Young Vin Im

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17904 Issued in CA

Practice address

1700 Adams Ave Ste 103
Costa Mesa, CA 92626-4865

Phone

(714) 556-2288

Fax

(714) 435-1745

NPI assigned

Sep 19, 2017

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

Occupational Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Rehabilitation Physical Therapy PCGroup PAC ID 0941604417, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: young.im.p46@direct.newportmed.nextgenshare.com

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.

• Functional Rehabilitation Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Lakewood, CA
  • NPI 1063083723
  Medicare reassignment Care Compare group NPD
• Advanced Orthopedic Physical Therapy

  • Physical Therapy Clinic/Center
  • Signal Hill, CA
  • NPI 1205931482
  Medicare reassignment NPD
• Feld Care Therapy Inc

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1770069338

  Occupational Therapist

  Medicare reassignment NPD
• Hands on Hands Rehabilitation Center, Inc.

  • Occupational Therapist
  • Huntington Beach, CA
  • NPI 1245403906
  NPD (past)
• Rehabilitation Dynamics Inc

  • Physical Therapist
  • Lakewood, CA
  • NPI 1548460157

  Occupational Therapist

  NPD (past)
• Feld Care Therapy Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1134075864

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497274617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 MADIA CIR",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231926",
            "telephone_number": "714-402-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ADAMS AVE STE 103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264865",
            "telephone_number": "714-556-2288",
            "fax_number": "714-435-1745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16152 Beach Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926473861",
            "country_code": "US",
            "telephone_number": "714-842-6202",
            "fax_number": "714-842-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IM",
        "first_name": "YOUNG",
        "middle_name": "VIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "17904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.