Matthew Ryan Kiminki, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT297270 Issued in CA

Practice address

44025 Jefferson St Ste 104
La Quinta, CA 92253-4874

Phone

(760) 345-5453

Fax

(760) 345-7063

NPI assigned

Oct 8, 2019

Last updated

Oct 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hooman M Javanmardi Physical Therapist a Professional CorporationGroup PAC ID 1254463318, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2241/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hooman M. Javanmardi, Physical Therapist, a Professional Corporation

  dba PRIME Therapy & Pain Center

  • Physical Therapist
  • Riverside, CA
  • NPI 1306163142
  Medicare reassignment Care Compare group NPD
• Hamid Mir MD Inc

  dba Evolve Orthopedics and Spine Institute

  • Orthopaedic Surgery of the Spine Physician
  • Tustin, CA
  • NPI 1972666840
  NPD (past)
• Hooman M Javanmardi, Physical Therapist, a Professional Corporation

  • Physical Therapist
  • Tustin, CA
  • NPI 1225984420
  NPD (past)

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1376185637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 CASA LINDA CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925551884",
            "telephone_number": "760-345-5453",
            "fax_number": "760-345-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44025 JEFFERSON ST STE 104",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534874",
            "telephone_number": "760-345-5453",
            "fax_number": "760-345-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMINKI",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Holloway Kelvin
• Holli Rae Kenley, M.A.
• Veronica M Kennedy, PTA
• Sipan Keshishyan, RPH
• Kids Health First Pediatrics Inc.
• Karen Lawes Kinder, BCBA
• Susan M Kingsley, LMHC
• Veronica Klein, NP
• Knight Chiropractic, Inc.
• Charles Duane Knight, D.C.

• Physical Therapist in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.