Individual provider Active NPI

Kazuto Robin Nakamura, DPT

  • Physical Therapist
  • Manhattan Beach, CA
National Provider Identifier
1366059545
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298613 Issued in CA
Practice address
1500 Rosecrans Ave Ste 550
Manhattan Beach, CA 90266-3722
Phone
(310) 643-9401
NPI assigned
Sep 30, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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 298613 CA Primary

Addresses

Primary practice location

1500 Rosecrans Ave Ste 550
Manhattan Beach, CA 90266-3722

Mailing address

1500 Rosecrans Ave Ste 550
Manhattan Beach, CA 90266-3722
Phone (310) 643-9401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210820002660 CA Practitioner - Physical Therapist in Private Practice 4789089269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

1111 N Brand Blvd
Suite Jandk
Glendale, CA 91202-3070
Phone (818) 244-0468

2001 Wilshire Blvd
Suite 310
Santa Monica, CA 90403-5683
Phone (310) 829-3320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298613CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Past Accepting new patients

Locations

1500 Rosecrans Ave
Ste 550
Manhattan Beach, CA 90266
Phone (310) 643-9401

1310 W Stewart Dr
Ste 404
Orange, CA 92868
Phone (714) 707-6466

935 E Ridgecrest Blvd
Ridgecrest, CA 93555
Phone (760) 371-1411

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1366059545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROSECRANS AVE STE 550",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663722",
            "telephone_number": "310-643-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSECRANS AVE STE 550",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663722",
            "telephone_number": "310-643-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "KAZUTO",
        "middle_name": "ROBIN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.