Individual provider Active NPI

Joe Akrabowon, PTA

  • Physical Therapy Assistant
  • Northridge, CA
National Provider Identifier
1659998342
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA50294 Issued in CA
Practice address
9545 Reseda Blvd Ste 4
Northridge, CA 91324-2351
Phone
(818) 886-2005
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X PTA50294 CA Primary

Addresses

Primary practice location

9545 Reseda Blvd Ste 4
Northridge, CA 91324-2351

Mailing address

9983 Stanwin Avenue
Arleta, CA 91331-5204
Phone (818) 554-3647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA50294CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JBP Physical Therapy Corporation Single Specialty CurrentSince Jul 5, 2020 Accepting new patients
Canyon Physical Therapy Inc. Single Specialty PastSince Jul 5, 2020 Accepting new patients

Locations

9545 Reseda Blvd
Ste 4
Northridge, CA 91324
Phone (818) 886-2005

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1659998342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9983 STANWIN AVENUE",
            "city": "ARLETA",
            "state": "CA",
            "postal_code": "913315204",
            "telephone_number": "818-554-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9545 RESEDA BLVD STE 4",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913242351",
            "telephone_number": "818-886-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKRABOWON",
        "first_name": "JOE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA50294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.