Individual provider Active NPI

Kelly Masuda

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1801261748
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
43335 Issued in CA
Practice address
10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943
Phone
(310) 286-0447
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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 43335 CA Primary

Addresses

Primary practice location

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943

Mailing address

10800 Palms Blvd Apt 7
Los Angeles, CA 90034-5558
Phone (310) 745-4558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160412001549 CA Practitioner - Physical Therapist in Private Practice 6608174420 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paulseth and Associates Physical Therapy IncGroup PAC ID 9638074073, 5 clinicians

Practice addresses (Care Compare)

10351 Santa Monica Blvd
Suite 101
Los Angeles, CA 90025-6943
Phone (310) 286-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43335CAMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Dec 6, 2022 Accepting new patients
Momentum Physical Therapy Physical Therapist CurrentSince Feb 5, 2007 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Dec 6, 2022 Accepting new patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist PastSince Dec 1, 2024 Accepting new patients

Locations

559 E Carson St
Ste B
Carson, CA 90745
Phone (424) 201-5242

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

11500 W Olympic Blvd
Ste 350
Los Angeles, CA 90064
Phone (310) 473-8287

10351 Santa Monica Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 286-0447

11500 W Olympic Blvd
Ste 470
Los Angeles, CA 90064
Phone (310) 473-8287

Organizations & group practices 5

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1801261748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 PALMS BLVD APT 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345558",
            "telephone_number": "310-745-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943",
            "telephone_number": "310-286-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUDA",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43335",
            "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 May 2, 2024; 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.