Benjamin Nabong, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30066 Issued in CA

Practice address

15211 Vanowen St
Suite 105
Van Nuys, CA 91405-3606

Phone

(818) 997-7711

Fax

(818) 997-3744

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Paraclete 38 Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • West Hills, CA
  • NPI 1558055921

  Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1417039405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15211 VANOWEN ST",
            "address_2": "SUITE 105",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053606",
            "telephone_number": "818-997-7711",
            "fax_number": "818-997-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15211 VANOWEN ST",
            "address_2": "SUITE 105",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053606",
            "telephone_number": "818-997-7711",
            "fax_number": "818-997-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABONG",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Bianca Myles
• N and B Patel M.D. Inc.
• N1 Healing Home Health Inc
• Tyler NA-Nakornpanom
• Farnaz Nabavi, D.D.S
• Marine Nadarian, LCSW
• Nader Rabi DDS Inc
• Askar Nadjafov, PHARMD
• Nagaraj M Chetty,M.D. Inc.
• Amina Nakandi

• Physical Therapist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.