NPIMap

Organization Active NPI

Agile Occupational Medicine, PC

  • Occupational Medicine Clinic/Center
  • Encino, CA
National Provider Identifier
1790556348
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
AGILE OCCUPATIONAL MEDICINE, PC
Practice address
16055 Ventura Blvd Ste 120
Encino, CA 91436-2635
Phone
(818) 386-5575
Fax
(818) 514-2024
NPI assigned
Jan 12, 2024
Last updated
May 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Authorized official

Name
Peter Murray
Title
Secretary
Phone
(571) 224-5886

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

16055 Ventura Blvd Ste 120
Encino, CA 91436-2635

Mailing address

3200 Bristol St Ste 600
Costa Mesa, CA 92626-1810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240320003959 CA Part B Supplier - Clinic/Group Practice 2567809957 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mission Hills, CA; Glendale, CA; Encino, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Agile Occupational Medicine PC49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777939200000",
    "number": "1790556348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 BRISTOL ST STE 600",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 120",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362635",
            "telephone_number": "818-386-5575",
            "fax_number": "818-514-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGILE OCCUPATIONAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "571-224-5886"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.