Individual provider Active NPI

Kai Wang, DPT

  • Physical Therapist
  • Walnut Creek, CA
National Provider Identifier
1366964165
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293190 Issued in CA
Practice address
301 Lennon LN Ste 202
Walnut Creek, CA 94598-2433
Phone
(925) 934-6373
Fax
(925) 934-3363
NPI assigned
Jul 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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 293190 CA Primary

Addresses

Primary practice location

301 Lennon LN Ste 202
Walnut Creek, CA 94598-2433

Mailing address

638 Maine St
Vallejo, CA 94590-6150
Phone (530) 400-9148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109003145 CA Practitioner - Physical Therapist in Private Practice 8123417342 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Edge, Inc.Group PAC ID 7214990399, 9 clinicians
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

1460 Drew Ave
Suite 200
Dans, CA 95618-4856
Phone (530) 753-9011

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293190CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Edge Specialty Services Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Dec 27, 2021 Accepting new patients
Physical Edge, Inc. Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Pleasanton Physical Therapy Services, Inc. Physical Therapist PastSince Apr 1, 2002 Accepting new patients

Locations

1460 Drew Ave
Ste 200
Davis, CA 95618
Phone (530) 753-9011

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

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": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499904000000",
    "number": "1366964165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 MAINE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945906150",
            "telephone_number": "530-400-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LENNON LN STE 202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982433",
            "telephone_number": "925-934-6373",
            "fax_number": "925-934-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KAI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; 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.