Individual provider Active NPI

Iman Akef Khowailed

  • Physical Therapist
  • Carlsbad, CA
National Provider Identifier
1457930489
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294170 Issued in CA
Practice address
920 Shore Crest Rd
Carlsbad, CA 92011-1131
Phone
(858) 252-8684
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 294170 CA Primary

Addresses

Primary practice location

920 Shore Crest Rd
Carlsbad, CA 92011-1131

Mailing address

920 Shore Crest Rd
Carlsbad, CA 92011-1131
Phone (858) 252-8684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402000984 NY Practitioner - Physical Therapist in Private Practice 0547663387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians

Practice addresses (Care Compare)

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Feb 11, 2025 Accepting new patients
Angela Yvonne Acupuncture Inc PastSince Apr 22, 2021 Accepting new patients

Locations

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1457930489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 SHORE CREST RD",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111131",
            "telephone_number": "858-252-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SHORE CREST RD",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111131",
            "telephone_number": "858-252-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOWAILED",
        "first_name": "IMAN",
        "middle_name": "AKEF",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.