Individual provider Active NPI

Kristina Miller, PT

  • Physical Therapist
  • Agoura Hills, CA
National Provider Identifier
1689772154
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29979 Issued in CA
Practice address
29229 Canwood St Ste 112
Agoura Hills, CA 91301-1561
Phone
(818) 501-7276
Fax
(818) 501-7288
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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 PT29979 CA Primary

Addresses

Primary practice location

29229 Canwood St Ste 112
Agoura Hills, CA 91301-1561

Mailing address

29229 Canwood St Ste 112
Agoura Hills, CA 91301-1561
Phone (818) 501-7276

Other names 1

  • Miss Kristina Nelsen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000617 CA Practitioner - Physical Therapist in Private Practice 9537120886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Primary Care Sports Medicine a Medical CorporationGroup PAC ID 2365488723, 6 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

18411 Clark St
Suite 302
Tarzana, CA 91356-3541
Phone (818) 501-7276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29979CAMDGeneral Practice Dentistry
PT29979CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Dec 28, 2023 Accepting new patients
Primary Care Sports Medicine a Medical Corporation CurrentSince May 26, 2024 Accepting new patients
Primary Care Sports Medicine a Medical Corporation CurrentSince May 26, 2024 Accepting new patients
Paulseth and Associates Physical Therapy Inc. Physical Therapist PastSince Oct 25, 1999 Accepting new patients

Locations

29229 Canwood St
Ste 112
Agoura Hills, CA 91301
Phone (818) 501-7276

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

18411 Clark St
Ste 302
Tarzana, CA 91356
Phone (818) 501-7276

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1689772154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29229 CANWOOD ST STE 112",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011561",
            "telephone_number": "818-501-7276",
            "fax_number": "818-501-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29229 CANWOOD ST STE 112",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913011561",
            "telephone_number": "818-501-7276",
            "fax_number": "818-501-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTINA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "NELSEN",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Agoura Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.