Individual provider Active NPI

Kevin Ortega, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1881057743
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302843 Issued in CA
Practice address
1640 Marengo St
Los Angeles, CA 90033-1036
Phone
(323) 865-1200
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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 302843 CA Primary

Addresses

Primary practice location

1640 Marengo St
Los Angeles, CA 90033-1036

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Other practice location 1

12121 Wilshire Blvd Ste 100
Los Angeles, CA 90025-1221
Phone (310) 477-7774

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014002840 CA Practitioner - Physical Therapist in Private Practice 9436646478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 S Fremont Ave
Alhambra, CA 91803-8800

PO Box
Suite 31309
Los Angeles, CA 90031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Orthosport Physical Therapy CurrentSince Sep 20, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2025 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2025 Accepting new patients
Elite Orthosport Performance Physical Therapy CurrentSince Sep 20, 2022 Accepting new patients

Locations

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

12121 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 477-4774

1640 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4091

1031 W 34th St
Los Angeles, CA 90089
Phone (213) 740-7711

Organizations & group practices 4

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1881057743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331036",
            "telephone_number": "323-865-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12121 Wilshire Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900251221",
            "country_code": "US",
            "telephone_number": "310-477-7774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "KEVIN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302843",
            "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 Nov 13, 2025; 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.