Individual provider Active NPI

Ryan L. Kahanu, DPT

  • Physical Therapist
  • Pacific Palisades, CA
National Provider Identifier
1962757245
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 39231 Issued in CA
Practice address
15200 W Sunset Blvd Ste 111
Pacific Palisades, CA 90272-3620
Phone
(310) 573-9340
Fax
(310) 573-9328
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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 PT 39231 CA Primary

Addresses

Primary practice location

15200 W Sunset Blvd Ste 111
Pacific Palisades, CA 90272-3620

Mailing address

24630 Washington Ave Ste 200
Murrieta, CA 92562-6177
Phone (951) 696-9353

Other practice location 1

671 W Naomi Ave
Arcadia, CA 91007-7502
Phone (626) 446-7027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331000299 TX Practitioner - Physical Therapist in Private Practice 4082863220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista JV Partners LLCGroup PAC ID 3274998224, 126 clinicians

Practice addresses (Care Compare)

5520 Sycamore School Rd
Suite 230
Fort Worth, TX 76123-3062
Phone (817) 423-1621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39231CAMDDentist
PT 39231CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista JV Partners LLC Physical Therapist CurrentSince Apr 3, 2023 Accepting new patients
Vista Rehab Partners, LP Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Vista Rehab Partners LP Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

1101 Raintree Cir
Ste 150
Allen, TX 75013
Phone (214) 383-9939

3535 Travis St
Ste 160
Dallas, TX 75204
Phone (214) 346-9105

1350 S Loop 288
Denton, TX 76205
Phone (940) 290-0500

5520 Sycamore School Rd
Fort Worth, TX 76123
Phone (817) 423-1621

8708 Medical City Way
Fort Worth, TX 76177
Phone (817) 345-0176

5520 Sycamore School Rd
Ste 230
Ft Worth, TX 76123
Phone (817) 423-1621

1650 W Rosedale St
Ste 305
Ft Worth, TX 76104
Phone (682) 841-1475

6060 Rocky Point Trl
Ste 100
Lake Worth, TX 76135
Phone (682) 289-9840

475 Elm St
Ste 200
Lewisville, TX 75057
Phone (945) 212-0050

5100 Eldorado Pkwy
#10220
McKinney, TX 75070
Phone (469) 310-1700

7720 Highway 78
Sachse, TX 75048
Phone (972) 761-5501

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1962757245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE STE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 W SUNSET BLVD STE 111",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723620",
            "telephone_number": "310-573-9340",
            "fax_number": "310-573-9328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 W Naomi Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910077502",
            "country_code": "US",
            "telephone_number": "626-446-7027",
            "fax_number": "626-446-4723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHANU",
        "first_name": "RYAN",
        "middle_name": "L.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 39231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.