Robin Joseph Pottukalam, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

38631 Issued in CA

Practice address

2550 Willow LN
Thousand Oaks, CA 91361-4945

Phone

(805) 497-7829

Fax

(805) 497-7839

NPI assigned

Feb 7, 2012

Last updated

Nov 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robin.pottukalam.p1@direct.lakeside.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD
• Feld Care Therapy Inc

  dba FeldCare Connects

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1770069338
  Medicare reassignment NPD
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Lancaster, CA
  • NPI 1982863783
  NPD
• Eugene Lee Physical Therapy& Wellness Center

  • Physical Therapy Clinic/Center
  • Thousand Oaks, CA
  • NPI 1255388468
  NPD (past)
• Lakeside Medical Associates, a Medical Group, Inc.

  dba Lakeside Community Healthcare Medical Group

  • Rheumatology Physician
  • Burbank, CA
  • NPI 1861499535
  NPD (past)
• Feld Care Therapy Inc

  • Physical Therapist
  • Tampa, FL
  • NPI 1134075864
  NPD (past)

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1982976866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 WILLOW LN",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614945",
            "telephone_number": "805-497-7829",
            "fax_number": "805-497-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 WILLOW LN",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614945",
            "telephone_number": "805-497-7829",
            "fax_number": "805-497-7839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "877-390-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTUKALAM",
        "first_name": "ROBIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-07",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Powercare Home Health Corporation

• Physical Therapist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.