Individual provider Active NPI

Kim Ngo Schaberg, PT

  • Physical Therapist
  • Broken Arrow, OK
National Provider Identifier
1902814510
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3679 Issued in OK
Practice address
2232 W Houston St
Broken Arrow, OK 74012-3529
Phone
(918) 259-9522
Fax
(918) 259-9521
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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 3679 OK Primary

Addresses

Primary practice location

2232 W Houston St
Broken Arrow, OK 74012-3529

Mailing address

2234-B W Houston
Broken Arrow, OK 74012-3519
Phone (918) 259-1888

Other identifiers 1

IdentifierTypeStateIssuer
200044970AMedicaidOK

Other names 1

  • Kim Y Ngo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000138 OK Practitioner - Physical Therapist in Private Practice 5597769638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Therapy Specialists, LLCGroup PAC ID 1759294689, 16 clinicians
Propel Physical TherapyGroup PAC ID 6103291521, 2 clinicians

Practice addresses (Care Compare)

2232 W Houston St
Broken Arrow, OK 74012-3529
Phone (918) 259-9522

24216 E Hwy 51
Broken Arrow, OK 74014-3473
Phone (918) 893-3409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3679OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince May 27, 2014 Accepting new patients
Excel Therapy Specialists, LLC Physical Therapist CurrentSince May 27, 2014 Accepting new patients
Propel Physical Therapy Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Orthopaedic and Sports Medicine Center-Norman, P.C. Past Accepting new patients

Locations

24216 E Highway 51
Broken Arrow, OK 74014
Phone (918) 519-0621

2234 W Houston St
Ste B
Broken Arrow, OK 74012
Phone (918) 259-1888

2232 W Houston St
Broken Arrow, OK 74012
Phone (918) 259-1888

2424 E 21st St
Ste 400
Tulsa, OK 74114
Phone (918) 743-9235

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1902814510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234-B W HOUSTON",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123519",
            "telephone_number": "918-259-1888",
            "fax_number": "918-251-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 W HOUSTON ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123529",
            "telephone_number": "918-259-9522",
            "fax_number": "918-259-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHABERG",
        "first_name": "KIM",
        "middle_name": "NGO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "NGO",
            "middle_name": "Y",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.