Individual provider Active NPI

Jennifer M Tam, PT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1720160807
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24625 Issued in CA
Practice address
3459 Cahuenga Blvd W
Los Angeles, CA 90068-1338
Phone
(323) 851-5000
Fax
(323) 472-9544
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 PT24625 CA Primary

Addresses

Primary practice location

3459 Cahuenga Blvd W
Los Angeles, CA 90068-1338

Mailing address

3459 Cahuenga Blvd W
Los Angeles, CA 90068-1338
Phone (323) 851-5000

Other practice location 1

222 W Eulalia St
Suite 101
Glendale, CA 91204-2849
Phone (818) 246-4800

Other names 1

  • Miss Jennifer M Yoshimura Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818001064 CA Practitioner - Physical Therapist in Private Practice 4082097415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, shared by 11 NPIs, 177 clinicians

Practice addresses (Care Compare)

12737 Glenoaks Blvd
Sylmar, CA 91342-4723
Phone (747) 260-1091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24625CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. Physical Therapist CurrentSince Jul 18, 2022 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jul 18, 2022 Accepting new patients
Proactive Work Health Medical Center Inc Past Accepting new patients

Locations

500 San Fernando Mission Blvd
Ste 100
San Fernando, CA 91340
Phone (323) 770-2871

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

12737 Glenoaks Blvd
Ste 1
Sylmar, CA 91342
Phone (747) 260-1091

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1720160807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 CAHUENGA BLVD W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681338",
            "telephone_number": "323-851-5000",
            "fax_number": "323-472-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 CAHUENGA BLVD W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900681338",
            "telephone_number": "323-851-5000",
            "fax_number": "323-472-9544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W Eulalia St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912042849",
            "country_code": "US",
            "telephone_number": "818-246-4800",
            "fax_number": "818-246-4805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAM",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "YOSHIMURA",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jul 10, 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.