Individual provider Active NPI

Michael Ibrahim Karim, DPT

  • Physical Therapist
  • Chino, CA
National Provider Identifier
1629545876
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295705 Issued in CA
Practice address
14682 Central Ave
Chino, CA 91710-9505
Phone
(909) 217-3664
Fax
(951) 684-2980
NPI assigned
Oct 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 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 PT295705 CA Primary

Addresses

Primary practice location

14682 Central Ave
Chino, CA 91710-9505

Mailing address

3191 Mission Inn Ave Ste B
Riverside, CA 92507-4188
Phone (951) 684-2874

Other practice location 1

3191 Mission Inn Ave Ste B
Riverside, CA 92507-4188
Phone (951) 684-2874

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190514003242 CA Practitioner - Physical Therapist in Private Practice 6204179203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3191 Mission Inn Ave
Suite B
Riverside, CA 92507-4188
Phone (951) 684-2874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marketplace Physical Therapy Inc, a Professional Corporation Physical Therapist CurrentSince Feb 23, 2021 Accepting new patients
Lifted Performance Physical Therapy Inc Physical Therapist Current Accepting new patients

Locations

14682 Central Ave
Chino, CA 91710
Phone (909) 217-3664

210 E Citrus Ave
Redlands, CA 92373
Phone (951) 376-3380

500 Orange St
Redlands, CA 92374
Phone (951) 376-3380

4270 Riverwalk Pkwy
Ste 114
Riverside, CA 92505
Phone (951) 324-4291

4270 Riverwalk Pkwy
Riverside, CA 92505

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1629545876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 MISSION INN AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074188",
            "telephone_number": "951-684-2874",
            "fax_number": "951-684-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14682 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109505",
            "telephone_number": "909-217-3664",
            "fax_number": "951-684-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3191 Mission Inn Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925074188",
            "country_code": "US",
            "telephone_number": "951-684-2874",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARIM",
        "first_name": "MICHAEL",
        "middle_name": "IBRAHIM",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-25",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.