Kenneth Satoru Kunisaki, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

300719 Issued in CA

Practice address

301 N Lake Ave Ste 201
Pasadena, CA 91101-5120

Phone

(626) 568-9115

Fax

(616) 568-9232

NPI assigned

Jun 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Select CS Physical Therapy, P.C.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ridgecrest, CA
  • NPI 1386228302

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1952979940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N LAKE AVE STE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015120",
            "telephone_number": "626-568-9115",
            "fax_number": "616-568-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N LAKE AVE STE 201",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015120",
            "telephone_number": "626-568-9115",
            "fax_number": "616-568-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNISAKI",
        "first_name": "KENNETH",
        "middle_name": "SATORU",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-09-09",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000022656",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nishan Kumaraperu
• Kumarx Pharmacy Apc (Old Pasadena Pharmacy)
• Nicolette Natalia Kumkowski, BA PSYCHOLOGY
• Shalin Kumra
• Michelle Atanante Kung, LAC., PH.D.
• Sheikh Omar Kunjo
• Brent Kenneth Kunkel
• Jennifer Kunst, PHD
• Anne Kuo, D.O.
• David Wayne Kuo, D.C.

• 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 Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.