Individual provider Active NPI

Ki Cheng, DPT

  • Physical Therapist
  • Oakland, CA
National Provider Identifier
1407416910
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5427 Telegraph Ave Ste W1
Oakland, CA 94609-1969
Phone
(510) 603-5440
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 Primary

Addresses

Primary practice location

5427 Telegraph Ave Ste W1
Oakland, CA 94609-1969

Mailing address

2930 Domingo Ave # 1471
Berkeley, CA 94705-2454
Phone (510) 603-5440

Other practice location 1

3701 Broadway
Oakland, CA 94611-5613
Phone (510) 752-6179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey Performance Physical Therapy, Inc. Current Accepting new patients
Opus Physical Therapy, PC CurrentSince Sep 24, 2023 Accepting new patients
Soma Sport and Physio Eng Chiropractic Inc Physical Therapist PastSince May 22, 2022 Accepting new patients

Locations

2930 Domingo Ave
Berkeley, CA 94705
Phone (510) 431-8114

5427 Telegraph Ave
Ste W1
Oakland, CA 94609
Phone (510) 603-5440

Organizations & group practices 3

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1407416910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 DOMINGO AVE # 1471",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052454",
            "telephone_number": "510-603-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5427 TELEGRAPH AVE STE W1",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091969",
            "telephone_number": "510-603-5440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3701 Broadway",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946115613",
            "country_code": "US",
            "telephone_number": "510-752-6179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENG",
        "first_name": "KI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.