Individual provider Active NPI

Kimberly Ann Liptak, PT

  • Physical Therapist
  • Cerritos, CA
National Provider Identifier
1982655890
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20508 Issued in CA
Practice address
19141 Bloomfield Ave
Cerritos, CA 90703-7104
Phone
(562) 924-8837
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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 PT20508 CA Primary

Addresses

Primary practice location

19141 Bloomfield Ave
Cerritos, CA 90703-7104

Mailing address

3321 Roxanne Ave
Long Beach, CA 90808-4326
Phone (562) 938-1510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001975 CA Practitioner - Physical Therapist in Private Practice 3678558996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

19141 Bloomfield Ave
Cerritos, CA 90703-7104
Phone (562) 924-8837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20508CAMDPhysical Therapist
20508CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
PCPT, Inc Physical Therapist CurrentSince Aug 1, 2007 Accepting new patients
Center of Rehab Excellence, a Physical Therapy Corporation Physical Therapist PastSince Apr 1, 2006 Accepting new patients
Pro Care Physical Therapy Past Accepting new patients

Locations

19141 Bloomfield Ave
Cerritos, CA 90703
Phone (562) 924-8837

Organizations & group practices 3

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1982655890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 ROXANNE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908084326",
            "telephone_number": "562-938-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19141 BLOOMFIELD AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907037104",
            "telephone_number": "562-924-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.