Individual provider Active NPI

Reid Fujimoto

  • Physical Therapist
  • Long Beach, CA
National Provider Identifier
1235916040
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1020 Termino Ave
Long Beach, CA 90804-4123
Phone
(562) 433-6791
NPI assigned
Sep 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1020 Termino Ave
Long Beach, CA 90804-4123

Mailing address

1020 Termino Ave
Long Beach, CA 90804-4123
Phone (562) 433-6791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726002062 CA Practitioner - Physical Therapist in Private Practice 1254877186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pro-Health Physical Therapy Inc.Group PAC ID 3476581109, 7 clinicians

Practice addresses (Care Compare)

2850 Artesia Blvd
Suite 207
Redondo Beach, CA 90278-3413
Phone (310) 371-4774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Health Physical Therapy Inc. Physical Therapist CurrentSince Jul 10, 2024 Accepting new patients
Kiley Chiropractic PastSince Jul 10, 2024 Accepting new patients

Locations

2850 Artesia Blvd
Ste 207
Redondo Beach, CA 90278
Phone (310) 371-4774

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1235916040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044123",
            "telephone_number": "562-433-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TERMINO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044123",
            "telephone_number": "562-433-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUJIMOTO",
        "first_name": "REID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.