Individual provider Active NPI

Jacob Richard Moyer, PT, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1548815665
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297092 Issued in CA
Practice address
1965 Hillhurst Ave FL 1
Los Angeles, CA 90027-2711
Phone
(323) 912-9166
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 297092 CA Primary

Addresses

Primary practice location

1965 Hillhurst Ave FL 1
Los Angeles, CA 90027-2711

Mailing address

1965 Hillhurst Ave FL 1
Los Angeles, CA 90027-2711
Phone (323) 912-9166

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003001784 CA Practitioner - Physical Therapist in Private Practice 6002147105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Herman Ostrow School of Dentistry of Usc, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moti Physiotherapy IncGroup PAC ID 4587920426, 19 clinicians

Practice addresses (Care Compare)

1965 Hillhurst Ave
FL 1
Los Angeles, CA 90027-2711
Phone (323) 912-9166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
297092CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 8, 2019 Accepting new patients
Moti Physiotherapy, Inc. Physical Therapist CurrentSince Sep 5, 2019 Accepting new patients
Moti Physiotherapy, Inc. CurrentSince Oct 6, 2019 Accepting new patients

Locations

5534 Westlawn Ave
Los Angeles, CA 90066
Phone (323) 853-8553

1965 Hillhurst Ave
Fl 1
Los Angeles, CA 90027
Phone (323) 912-9166

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1548815665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 HILLHURST AVE FL 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272711",
            "telephone_number": "323-912-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 HILLHURST AVE FL 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900272711",
            "telephone_number": "323-912-9166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYER",
        "first_name": "JACOB",
        "middle_name": "RICHARD",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.