KANOSHA CREE GRADY PT, DPT, LAT, ATC
NPI 1093256034
Student in an Organized Health Care Education/Training Program in Los Angeles, CA
About Kanosha Cree Grady Pt, Dpt, Lat, Atc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KANOSHA CREE GRADY PT, DPT, LAT, ATC (NPI 1093256034) is an individual student in an organized health care education/training program in Los Angeles, California and active in the NPI registry since March 2017. She is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kanosha Cree Grady Pt, Dpt, Lat, Atc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kanosha Grady reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Gatos, CA 95032
- Reassigned Medicare billing, California enrollment
- 1,388 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kanosha Grady's NPI number?
The NPI number for Kanosha Grady is 1093256034. It was assigned to this individual provider in the NPPES registry on March 9, 2017.
Where is Kanosha Grady located?
Kanosha Grady practices at 5550 Wilshire Blvd, Los Angeles, CA 90036. The listed phone number is (702) 502-1018.
What is Kanosha Grady's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Kanosha Grady enrolled in Medicare?
Yes. Kanosha Grady is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kanosha Grady's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kanosha Grady reassigns Medicare benefits to California Luna Care Physical Therapy PC (Los Gatos, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kanosha Grady's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kanosha Grady was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kanosha Cree Grady, PT, DPT, LAT, ATC · NPI 1093256034
Student in an Organized Health Care Education/Training Program provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since March 9, 2017.
## Identity
- **NPI:** 1093256034 (Entity type: Individual)
- **Enumerated:** March 9, 2017
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 5550 WILSHIRE BLVD, Los Angeles, CA 90036-3809
- **Phone:** (702) 502-1018
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** California Luna Care Physical Therapy PC (NPI 1689162166, Los Gatos, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** July 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1093256034) · Data from the CMS NPPES public registry.