Individual provider Active NPI

Sepehr Koliny, DPT

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1386531788
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT308130 Issued in CA
Practice address
17000 Ventura Blvd Ste 103
Encino, CA 91316-4187
Phone
(818) 995-4488
Fax
(818) 995-3140
NPI assigned
Jun 19, 2025
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 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 PT308130 CA Primary

Addresses

Primary practice location

17000 Ventura Blvd Ste 103
Encino, CA 91316-4187

Mailing address

17000 Ventura Blvd Ste 103
Encino, CA 91316-4187
Phone (818) 995-4488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251027003812 CA Practitioner - Physical Therapist in Private Practice 4880183284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17000 Ventura Blvd
Suite 103
Encino, CA 91316-4179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT308130CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S2 Physical Therapy & Rehab Physical Therapist CurrentSince Aug 20, 2025 Accepting new patients

Locations

17000 Ventura Blvd
Ste 103
Encino, CA 91316
Phone (818) 624-6180

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1386531788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 VENTURA BLVD STE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164187",
            "telephone_number": "818-995-4488",
            "fax_number": "818-995-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 VENTURA BLVD STE 103",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164187",
            "telephone_number": "818-995-4488",
            "fax_number": "818-995-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLINY",
        "first_name": "SEPEHR",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT308130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.