Active Life Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ACTIVE LIFE PHYSICAL THERAPY, INC.

Practice address

5065 Hollywood Blvd
Suite 201
Los Angeles, CA 90027-6122

Phone

(323) 481-4697

NPI assigned

Nov 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Stephen Jason Wilkins, DPTNPI 1336317684

Title

President

Phone

(323) 481-4697

Specialties & licenses 1

Addresses

Other names 1

• Active Physical Therapy & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Jason Wilkins, DPT

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1336317684
  Medicare reassignment NPD Authorized official
• Eric Choi, DPT

  • Physical Therapist
  • Glendale, CA
  • NPI 1306154398
  NPD
• Kevork Keurjikian

  • Physical Therapist
  • North Hollywood, CA
  • NPI 1417633645
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1225330616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5065 HOLLYWOOD BLVD STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276122",
            "telephone_number": "323-665-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5065 HOLLYWOOD BLVD",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276122",
            "telephone_number": "323-481-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-481-4697",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Physical Therapy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Action Rehab Center Inc.
• Action Rehab Center Inc.
• Action Sober Living
• Active Care Home Health, Inc.
• Active Health Physical Therapy, Inc.
• Active Life, LLC
• Active Life, LLC
• Active Medical Equipment & Supplis
• Active Mobile Medical Group, Inc.
• Active Pain Relief Inc

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.