Individual provider Active NPI

Dongwon Jahng, D.P.T.

  • Physical Therapist
  • Valencia, CA
National Provider Identifier
1568504207
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28833 Issued in CA
Practice address
27616 Newhall Ranch Rd
Suite 35
Valencia, CA 91355-3482
Phone
(661) 254-0488
Fax
(661) 254-0490
NPI assigned
Feb 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11597 CA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT28833 CA Primary

Addresses

Primary practice location

27616 Newhall Ranch Rd
Suite 35
Valencia, CA 91355-3482

Mailing address

26114 Salinger LN
Stevenson Ranch, CA 91381-1107
Phone (310) 474-5729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070321000662 CA Practitioner - Physical Therapist in Private Practice 5698878171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Socal Physical Therapy IncGroup PAC ID 3779631445, 3 clinicians

Practice addresses (Care Compare)

27616 Newhall Ranch Rd
Unit 35
Valencia, CA 91355-4015
Phone (661) 254-0488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC11597CAMDAcupuncturist
PT28833CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Socal Physical Therapy Inc. Acupuncturist CurrentSince Jan 1, 2009 Accepting new patients
On the Move Physical Therapy, P.C. Multi-Specialty PastSince Jul 1, 2006 Accepting new patients
Pacific Sports Health Management, Inc. Multi-Specialty Past Accepting new patients

Locations

27616 Newhall Ranch Rd
Ste A35
Valencia, CA 91355

27616 Newhall Ranch Rd
Unit 35
Valencia, CA 91355
Phone (661) 254-0488

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1568504207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26114 SALINGER LN",
            "city": "STEVENSON RANCH",
            "state": "CA",
            "postal_code": "913811107",
            "telephone_number": "310-474-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27616 NEWHALL RANCH RD",
            "address_2": "SUITE 35",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553482",
            "telephone_number": "661-254-0488",
            "fax_number": "661-254-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHNG",
        "first_name": "DONGWON",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11597",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.