Individual provider Active NPI

Mars Jimenez, DPT

  • Physical Therapist
  • Beverly Hills, CA
National Provider Identifier
1376334045
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307988 Issued in CA
Practice address
201 N Robertson Blvd
Beverly Hills, CA 90211-1729
Phone
(424) 303-7647
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 307988 CA Primary

Addresses

Primary practice location

201 N Robertson Blvd
Beverly Hills, CA 90211-1729

Mailing address

4830 Elmwood Ave Apt 105
Los Angeles, CA 90004-3187
Phone (310) 941-2308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702002384 CA Practitioner - Physical Therapist in Private Practice 3173036001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Evolution Physical Therapy IncGroup PAC ID 0244336964, 72 clinicians

Practice addresses (Care Compare)

11825 Major St
Suite 107
Culver City, CA 90230-6356
Phone (310) 915-6100

201 N Robertson Blvd
Suite 101
Beverly Hills, CA 90211-1729
Phone (424) 303-7647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307988CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Physical Therapy, Inc Physical Therapist CurrentSince Jun 5, 2025 Accepting new patients
Next Phase Medical PC PastSince Sep 28, 2025 Accepting new patients

Locations

11825 Major St
Ste 107
Los Angeles, CA 90230
Phone (310) 915-6100

322 Culver Blvd
Playa del Rey, CA 90293
Phone (310) 461-8712

Organizations & group practices 2

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": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1376334045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 ELMWOOD AVE APT 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043187",
            "telephone_number": "310-941-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N ROBERTSON BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111729",
            "telephone_number": "424-303-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MARS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.