Individual provider Active NPI

Claire Keenan

  • Physical Therapist
  • Mission Viejo, CA
National Provider Identifier
1821820119
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306693 Issued in CA
Practice address
23382 Madero Ste a
Mission Viejo, CA 92691-2782
Phone
(949) 464-4009
Fax
(949) 534-0703
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 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 306693 CA Primary

Addresses

Primary practice location

23382 Madero Ste a
Mission Viejo, CA 92691-2782

Mailing address

23382 Madero Ste a
Mission Viejo, CA 92691-2782
Phone (949) 464-4009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918004103 CA Practitioner - Physical Therapist in Private Practice 3476094368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kinetik Physical Therapy IncGroup PAC ID 7911381207, 4 clinicians

Practice addresses (Care Compare)

23382 Madero
Suite a
Mission Viejo, CA 92691-2782
Phone (949) 464-4009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306693CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetik Physical Therapy Inc Physical Therapist CurrentSince Aug 20, 2024 Accepting new patients

Locations

23382 Madero
Ste A
Mission Viejo, CA 92691
Phone (949) 464-4009

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1821820119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23382 MADERO STE A",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912782",
            "telephone_number": "949-464-4009",
            "fax_number": "949-534-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23382 MADERO STE A",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926912782",
            "telephone_number": "949-464-4009",
            "fax_number": "949-534-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "CLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.