Active NPI
Mark Kozuki, PT
- Orthopedic Physical Therapist
- Costa Mesa, CA
National Provider Identifier
1316275191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 28190
- Practice address
- 2900 Bristol St
Building G 102
Costa Mesa, CA 92626-5981 - Phone
- (949) 467-9656
- NPI assigned
- Dec 6, 2009
- Last updated
- Dec 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 28190 | CA | Primary |
Addresses
Primary practice location
2900 Bristol St
Building G 102
Costa Mesa, CA 92626-5981
Mailing address
2900 Bristol St
Building G 102
Costa Mesa, CA 92626-5981
Phone (949) 467-9656
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28190 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HW Physical Therapy | Orthopedic | Past | Accepting new patients |
| Martin Orthopedic Rehabilitation Physical Therapy Inc. | Past | Accepting new patients | |
| Specialized Physical Therapy, Apc | Orthopedic | Past | Accepting new patients |
| Elite Performance Physical Therapy, Inc. | Orthopedic | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthopedic Physical Therapist
- Costa Mesa, CA
- NPI 1538409065
-
dba Specialized Physical Therapy
- Orthopedic Physical Therapist
- Tustin, CA
- NPI 1255829503
-
- Specialist
- San Juan Capistrano, CA
- NPI 1316987274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1316275191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 BRISTOL ST",
"address_2": "BUILDING G 102",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265981",
"telephone_number": "949-467-9656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 BRISTOL ST",
"address_2": "BUILDING G 102",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926265981",
"telephone_number": "949-467-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZUKI",
"first_name": "MARK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-06",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "28190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.