LAKESIDE PHYSICAL THERAPY, INC.
NPI 1093945891
Clinic/Center - Physical Therapy in Mission Viejo, CA
About Lakeside Physical Therapy, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKESIDE PHYSICAL THERAPY, INC. (NPI 1093945891) is a healthcare organization registered as a physical therapy in Mission Viejo, California and active in the NPI registry since July 2009. The organization lists Fred Hyungshik Kim, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lakeside Physical Therapy, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Lakeside Physical Therapy, Inc., which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Lakeside Physical Therapy, Inc.'s NPI number?
The NPI number for Lakeside Physical Therapy, Inc. is 1093945891. It was assigned to this organization in the NPPES registry on July 15, 2009.
Where is Lakeside Physical Therapy, Inc. located?
Lakeside Physical Therapy, Inc. is located at 27722 Vista Del Lago A1, Mission Viejo, CA 92692. The listed phone number is (949) 842-5735.
What is Lakeside Physical Therapy, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.
Is Lakeside Physical Therapy, Inc. enrolled in Medicare?
Yes. Lakeside Physical Therapy, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lakeside Physical Therapy, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Lakeside Physical Therapy, Inc.. A 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 the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Lakeside Physical Therapy, Inc. was last updated on July 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.
# Lakeside Physical Therapy, Inc. · NPI 1093945891
Physical Therapy organization in Mission Viejo, California. Organization record, active in the CMS NPPES registry since July 15, 2009.
## Identity
- **NPI:** 1093945891 (Entity type: Organization)
- **Enumerated:** July 15, 2009
- **Primary specialty:** Clinic/Center - Physical Therapy · taxonomy 261QP2000X
- **Organization subpart:** No
- **Authorized official:** Fred Kim, OWNER
## Practice location
- **Address:** 27722 VISTA DEL LAGO, A1, Mission Viejo, CA 92692-1133
- **Phone:** (949) 842-5735
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Physical Therapist in Private Practice) reassign Medicare billing to this organization (form CMS-855R); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 15, 2009
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Source: [NPI Profile](https://npiprofile.com/npi/1093945891) · Data from the CMS NPPES public registry.