Individual provider Active NPI

Kevin Reichel, PT, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1366055170
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298800 Issued in CA
Practice address
1640 Marengo St Ste 102
Los Angeles, CA 90033-1061
Phone
(323) 865-1200
NPI assigned
Aug 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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 298800 CA Primary

Addresses

Primary practice location

1640 Marengo St Ste 102
Los Angeles, CA 90033-1061

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-1200

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherCAPHYSICAL THERAPY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kevin.reichel@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201110000172 CA Practitioner - Physical Therapist in Private Practice 0042620668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1640 Marengo St
Los Angeles, CA 90033-1036
Phone (323) 223-4091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Dec 5, 2020 Accepting new patients
Physical Edge Physical Therapy Inc Physical Therapist CurrentSince Sep 8, 2020 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Dec 5, 2020 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

253 N Santa Anita Ave
Arcadia, CA 91006
Phone (626) 294-0070

1640 Marengo St
Ste 102
Los Angeles, CA 90033
Phone (323) 224-7070

1640 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4091

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1366055170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MARENGO ST STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331061",
            "telephone_number": "323-865-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHEL",
        "first_name": "KEVIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-31",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kevin.reichel@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1640 Marengo St Ste 102",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900331061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.