Kevin Chan Shum, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306654 Issued in CA

Practice address

842 E Villa St
Pasadena, CA 91101-1259

Phone

(626) 463-5350

NPI assigned

Jan 18, 2025

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sand Coast Rehab Physical Therapy IncGroup PAC ID 7315352911, 131 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sand Coast Rehab Physical Therapy Inc

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1639766603

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1737158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1942011838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6147 TEMPLE CITY BLVD UNIT D",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801765",
            "telephone_number": "626-236-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 E VILLA ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011259",
            "telephone_number": "626-463-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN SHUM",
        "first_name": "KEVIN",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-18",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandt Oliver Chamberlain, PSYCHOLOGIST
• Justin Michael Chambers
• Kathryn Anne Chambers, MFT
• Sandra Davis Champagne, RN.
• Annette Champo, MASSAGE THERAPIST
• Ariel Haydee Chan, PA-C
• Bethany J Chan, DPT
• Bonnie Jansum Chan
• Brian Chan
• Charissa Chan

• Physical Therapist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.