Timothy Novom, PT, DPT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299044 Issued in CA

Practice address

6214 W Manchester Ave
Los Angeles, CA 90045-3801

Phone

(310) 348-8464

NPI assigned

Sep 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Physical Therapy Care, Inc

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1033299029
  NPD

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1295340164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26409 ASHFORK PL",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902751701",
            "telephone_number": "310-989-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6214 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453801",
            "telephone_number": "310-348-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOM",
        "first_name": "TIMOTHY",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-02-10",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert James Novickas, LMFT
• Atieh Novin
• Novo Detox
• Michelle Novoa
• Meghan Novom, OTR/L
• Now Medical
• Marie Nowacki, PPD
• Alfred Theodore Jack Nowak, PT, DPT
• Kimberly Michelle Nowak, D.O.
• Maryam Nowakhtar, PHARM. D.

• 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 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.