Individual provider Active NPI

Kin Siu Ho, PT, DPT

  • Physical Therapist
  • West Covina, CA
National Provider Identifier
1992034433
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36306 Issued in CA
Practice address
100 N Barranca St Ste 380
West Covina, CA 91791-1637
Phone
(626) 331-8355
Fax
(626) 331-8165
NPI assigned
Dec 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 36306 CA Primary

Addresses

Primary practice location

100 N Barranca St Ste 380
West Covina, CA 91791-1637

Mailing address

1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434
Phone (909) 890-9030

Other identifiers 1

IdentifierTypeStateIssuer
1992034433MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100305000161 CA Practitioner - Physical Therapist in Private Practice 0244375913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 N Barranca St
West Covina, CA 91791-1637
Phone (626) 331-8355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Therapy Network Incorporated Physical Therapist Current Accepting new patients
United Therapy Network Incorporated Physical Therapist CurrentSince Oct 28, 2019 Accepting new patients
United Therapy Network Incorporated Physical Therapist CurrentSince Oct 28, 2019 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Past Accepting new patients

Locations

802 Magnolia Ave
Ste 107
Corona, CA 92879
Phone (951) 340-0070

1902 Royalty Dr
Ste 220
Pomona, CA 91767
Phone (909) 570-3108

1845 Business Center Dr
Ste 127
Sn Bernrdno, CA 92408
Phone (909) 890-9030

100 N Barranca St
Ste 380
West Covina, CA 91791
Phone (626) 331-8355

855 N Lark Ellen Ave
Ste J
West Covina, CA 91791
Phone (626) 331-8355

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kin.ho.p1@direct.lakeside.nextgenshare.com

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": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1992034433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 380",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911637",
            "telephone_number": "626-331-8355",
            "fax_number": "626-331-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "KIN",
        "middle_name": "SIU",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-11",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992034433",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.