Individual provider Active NPI

Jeff Lang

  • Physical Therapist
  • Beverly Hills, CA
National Provider Identifier
1740609635
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19266 Issued in CA
Practice address
415 N Crescent Dr
Suite 130
Beverly Hills, CA 90210-4860
Phone
(310) 828-0101
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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 PT19266 CA Primary

Addresses

Primary practice location

415 N Crescent Dr
Suite 130
Beverly Hills, CA 90210-4860

Mailing address

920 Marco PL
Venice, CA 90291-3920
Phone (310) 828-0101

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19266CAMDCounseling Psychologist
PT19266CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adi Rehab, Incorporated Physical Therapist PastSince Nov 24, 2019 Accepting new patients

Organizations & group practices 1

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1740609635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MARCO PL",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913920",
            "telephone_number": "310-828-0101",
            "fax_number": "310-828-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CRESCENT DR",
            "address_2": "SUITE 130",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104860",
            "telephone_number": "310-828-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "JEFF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT19266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.