Individual provider Active NPI

Kahl Goldfarb, DPT, DMT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1871669622
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23900 Issued in CA
Practice address
3115 Ocean Front Walk
San Diego, CA 92109-8729
Phone
(858) 488-3597
Fax
(858) 488-3178
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 PT23900 CA Primary

Addresses

Primary practice location

3115 Ocean Front Walk
San Diego, CA 92109-8729

Mailing address

3639 Midway Dr Ste B286
San Diego, CA 92110-5254
Phone (858) 488-3597

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000680 CA Practitioner - Physical Therapist in Private Practice 9537150313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Water and Sports Physical Therapy IncGroup PAC ID 2365433232, 22 clinicians

Practice addresses (Care Compare)

12234 Poway Rd
Poway, CA 92064-4200
Phone (858) 488-3597

501 W Broadway
San Diego, CA 92101-3536
Phone (858) 488-3597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23900CAMDPsychologist
PT23900CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoeck Physical Therapy, Inc Physical Therapist Current Accepting new patients
Water and Sports Physical Therapy, Inc Physical Therapist CurrentSince Jan 1, 2002 Accepting new patients
Water and Sports Physical Therapy Past Accepting new patients

Locations

3639 Midway Dr
Ste B286
San Diego, CA 92110
Phone (858) 724-1747

3639 Midway Dr
#B286
San Diego, CA 92110

3115 Ocean Front Walk
San Diego, CA 92109
Phone (619) 922-6161

501 W Broadway
San Diego, CA 92101
Phone (619) 237-9027

9875 Aviary Dr
San Diego, CA 92131

Organizations & group practices 3

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871669622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 MIDWAY DR STE B286",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105254",
            "telephone_number": "858-488-3597",
            "fax_number": "858-488-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 OCEAN FRONT WALK",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921098729",
            "telephone_number": "858-488-3597",
            "fax_number": "858-488-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "KAHL",
        "credential": "DPT, DMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.