NPIMap

Organization Active NPI

Cypress Physical Therapy Center, Inc.

  • Orthopedic Physical Therapist
  • Pacific Palisades, CA
National Provider Identifier
1831977230
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
CYPRESS PHYSICAL THERAPY CENTER, INC.
Practice address
860 Via de la Paz Ste B1
Pacific Palisades, CA 90272-3681
Phone
(310) 573-9553
NPI assigned
Sep 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Mrs. Kimberly Jean Russell, PTNPI 1992718837
Title
Physical Therapist
Phone
(801) 589-9909

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
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

860 Via de la Paz Ste B1
Pacific Palisades, CA 90272-3681

Mailing address

6014 W 82ND St
Los Angeles, CA 90045-3001
Phone (801) 589-9909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231020000887 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890141279 Receives reassigned benefits from 9 practitioners
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

1811 Centinela Ave
Santa Monica, CA 90404
Phone (310) 573-9553

Practitioners & affiliated clinicians

Practitioners 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1831977230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6014 W 82ND ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453001",
            "telephone_number": "801-589-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 VIA DE LA PAZ STE B1",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723681",
            "telephone_number": "310-573-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS PHYSICAL THERAPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "801-589-9909",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.