Individual provider Active NPI

Jason Raymond Molina, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1497195770
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40474 Issued in CA
Practice address
11639 Creekstone LN
San Diego, CA 92128-6338
Phone
(858) 344-4989
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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 40474 CA Primary

Addresses

Primary practice location

11639 Creekstone LN
San Diego, CA 92128-6338

Mailing address

11639 Creekstone LN
San Diego, CA 92128-6338
Phone (858) 344-4989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160930000648 CA Practitioner - Physical Therapist in Private Practice 1557658846 Reassigns benefits to 2 organizations
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kuhn Physical Therapy and Wellness, Inc Physical Therapist CurrentSince May 1, 2021 Accepting new patients
Molina Physical Therapy Inc Physical Therapist CurrentSince Jul 20, 2022 Accepting new patients

Locations

4070 Voltaire St
San Diego, CA 92107
Phone (619) 391-8688

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1497195770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11639 CREEKSTONE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921286338",
            "telephone_number": "858-344-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11639 CREEKSTONE LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921286338",
            "telephone_number": "858-344-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "JASON",
        "middle_name": "RAYMOND",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.