Individual provider Active NPI

Ryan David King, D.P.T.

  • Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1356886600
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292587 Issued in CA
Practice address
1600 Dove St Ste 100
Newport Beach, CA 92660-2438
Phone
(949) 502-3388
NPI assigned
Dec 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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 292587 CA Primary

Addresses

Primary practice location

1600 Dove St Ste 100
Newport Beach, CA 92660-2438

Mailing address

1600 Dove St Ste 100
Newport Beach, CA 92660-2438
Phone (949) 502-3388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608001445 CA Practitioner - Physical Therapist in Private Practice 3173891546 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Pro X Physical Therapy PCGroup PAC ID 0547508467, 5 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

30851 Agoura Rd
Suite 300
Agoura Hills, CA 91301-4346
Phone (818) 532-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
292587CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashwood Physical Therapy, Inc. Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Pro X Physical Therapy PC CurrentSince Jul 23, 2024 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 10, 2022 Accepting new patients
Sansum Clinic Past Accepting new patients

Locations

30851 Agoura Rd
Ste 300
Agoura Hills, CA 91301
Phone (818) 532-7600

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

3737 Telegraph Rd
Ste A
Ventura, CA 93003
Phone (805) 642-4678

Organizations & group practices 5

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": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1356886600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602438",
            "telephone_number": "949-502-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602438",
            "telephone_number": "949-502-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.