NPIMap

Organization Active NPI

Kinetic Orthopaedic Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1780123075
Registry record updated Jun 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT10216 Issued in CA
Legal business name
KINETIC ORTHOPAEDIC PHYSICAL THERAPY, INC.
Practice address
1950 Sawtelle Blvd
Suite 190
Los Angeles, CA 90025
Phone
(310) 312-5678
NPI assigned
Feb 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2017

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

Authorized official

Name
Dr. David H. Pakozdi, PT, OCSNPI 1992843205
Title
Owner/Director
Phone
(310) 312-5678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT10216 CA Primary

Addresses

Primary practice location

1950 Sawtelle Blvd
Suite 190
Los Angeles, CA 90025

Mailing address

1950 Sawtelle Blvd
Suite 190
Los Angeles, CA 90025-7014
Phone (310) 312-5678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170718000572 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577833953 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1950 Sawtelle Blvd
Ste 190
Los Angeles, CA 90025
Phone (310) 312-5678

12301 Wilshire Blvd
Ste 404
Los Angeles, CA 90025
Phone (310) 312-5678

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497571200000",
    "number": "1780123075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SAWTELLE BLVD",
            "address_2": "SUITE 190",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257014",
            "telephone_number": "310-312-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SAWTELLE BLVD",
            "address_2": "SUITE 190",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-312-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC ORTHOPAEDIC PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-06-16",
        "status": "A",
        "authorized_official_last_name": "PAKOZDI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "310-312-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT10216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.