Individual provider Active NPI

John R Koegel, DPT

  • Physical Therapist
  • Beverly Hills, CA
National Provider Identifier
1396930244
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9352 Issued in CA
Practice address
8920 Wilshire Blvd
Suite 335
Beverly Hills, CA 90211-2007
Phone
(310) 659-3018
Fax
(310) 657-0816
NPI assigned
Sep 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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 PT9352 CA Primary

Addresses

Primary practice location

8920 Wilshire Blvd
Suite 335
Beverly Hills, CA 90211-2007

Mailing address

8920 Wilshire Blvd
Suite 335
Beverly Hills, CA 90211-2007
Phone (310) 659-3018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719002379 GA Practitioner - Physical Therapist in Private Practice 8426950080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9352CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
John Koegel, PT Inc. Current Accepting new patients
John R. Koegel, P.T., Inc Physical Therapist Current Accepting new patients
Complete P T Pool and Land Physical Therapy Inc Past Accepting new patients

Locations

8920 Wilshire Blvd
Ste 335
Beverly Hills, CA 90211
Phone (310) 657-2178

Interoperability endpoints

  • Direct secure messaging: john.koegel.1@15749.direct.athenahealth.com

Organizations & group practices 5

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1396930244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "SUITE 335",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112007",
            "telephone_number": "310-659-3018",
            "fax_number": "310-657-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "SUITE 335",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112007",
            "telephone_number": "310-659-3018",
            "fax_number": "310-657-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEGEL",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9352",
            "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 Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.