Jimmy Bo Duong, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300856 Issued in CA

Practice address

16897 Algonquin St Ste 101
Huntington Beach, CA 92649-3811

Phone

(714) 841-6162

Fax

(714) 841-9912

NPI assigned

Aug 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Proactive Physical Therapy and Sports Medicine IncGroup PAC ID 1557369436, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Proactive Physical Therapy & Sports Medicine Inc

  • Physical Therapy Clinic/Center
  • Carlsbad, CA
  • NPI 1285729509

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Huntington Beach Physical Therapy Specialist a Professional Corp

  • Physical Therapist
  • Huntington Beach, CA
  • NPI 1073650834
  Medicare reassignment NPD
• DPT Holdings PLLC

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1891462669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16897 ALGONQUIN ST STE 101",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493811",
            "telephone_number": "714-841-6162",
            "fax_number": "714-841-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16897 ALGONQUIN ST STE 101",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493811",
            "telephone_number": "714-841-6162",
            "fax_number": "714-841-9912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19582 Beach Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926485924",
            "country_code": "US",
            "telephone_number": "714-841-6162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "JIMMY",
        "middle_name": "BO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "300856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Duncker
• Tiffany Dunlap
• Janette Lyn Dunn, MA
• Betty Duong
• Bryan Duong
• Kim Nga Duong, LCSW
• Kristine Duong
• Kyla Duong
• Mary Duong
• Nathaniel Duong

• Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.