Individual provider Active NPI

Jonathan Kim, PT, DPT

  • Orthopedic Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1780497479
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
12424 Wilshire Blvd
Los Angeles, CA 90025-1052
Phone
(310) 826-2977
NPI assigned
Jan 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

12424 Wilshire Blvd
Los Angeles, CA 90025-1052

Mailing address

1517 S Van Ness Ave
Los Angeles, CA 90019-4632
Phone (818) 983-6778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227001839 CA Practitioner - Physical Therapist in Private Practice 3870013360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletic Physical Therapy IncGroup PAC ID 6507821436, 10 clinicians

Practice addresses (Care Compare)

12424 Wilshire Blvd
Suite 101
Los Angeles, CA 90025-1064
Phone (310) 826-2977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic Physical Therapy Inc CurrentSince Jan 1, 2025 Accepting new patients
Athletic Physical Therapy, Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

12424 Wilshire Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 826-2977

12424 Wilshire Blvd
Los Angeles, CA 90025
Phone (310) 571-8760

30837 E Thousand Oaks Blvd
Westlake Village, CA 91362
Phone (818) 340-2002

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1780497479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 S VAN NESS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900194632",
            "telephone_number": "818-983-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12424 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251052",
            "telephone_number": "310-826-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONATHAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "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 Jan 28, 2025; 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.