Individual provider Active NPI

Kurt Koeppen, PT

  • Physical Therapist
  • Palo Alto, CA
National Provider Identifier
1366489304
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16073 Issued in CA
Practice address
3441 Alma St
Suite 200
Palo Alto, CA 94306-3506
Phone
(650) 323-4440
Fax
(650) 323-4441
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 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 16073 CA Primary

Addresses

Primary practice location

3441 Alma St
Suite 200
Palo Alto, CA 94306-3506

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 1

IdentifierTypeStateIssuer
16073OtherCAPT LICENCE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000257 CA Practitioner - Physical Therapist in Private Practice 8022045608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard P Carr Physical Therapy IncGroup PAC ID 9830182070, 28 clinicians

Practice addresses (Care Compare)

3441 Alma St
Suite 200
Palo Alto, CA 94306-3508
Phone (650) 323-4440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard P. Carr Physical Therapy Inc Physical Therapist CurrentSince Mar 29, 2021 Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist CurrentSince Mar 29, 2021 Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist Current Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

605 Tennant Ave
Ste F
Morgan Hill, CA 95037
Phone (408) 778-3434

3441 Alma St
Ste 200
Palo Alto, CA 94306
Phone (650) 323-4440

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1366489304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 ALMA ST",
            "address_2": "SUITE 200",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943063506",
            "telephone_number": "650-323-4440",
            "fax_number": "650-323-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPPEN",
        "first_name": "KURT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "16073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENCE #",
            "identifier": "16073",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.