PETER WIBISONO PT
NPI 1366654469
Physical Therapist in Woodland Hills, CA

Active since May 03, 2007
5601 DE SOTO AVE, WOODLAND HILLS, CA 91367(818) 719-2773 Get Directions Write a Review

NPPES record last updated: January 13, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 13, 2022, Dec 2, 2021 (2 updates tracked since 2021).

About Peter Wibisono Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETER WIBISONO PT (NPI 1366654469) is an individual physical therapist in Woodland Hills, California, licensed in California (26160) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1366654469
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NamePETER WIBISONOCredential: PT
Location Address5601 DE SOTO AVEWoodland Hills, CA 91367-6701
Mailing Address1526 N Edgemont StLos Angeles, CA 90027-5260 · (323) 783-8070
Sole ProprietorNo
Enumeration DateMay 3, 2007
Last NPPES UpdateJanuary 13, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2022
✔ NPI 1366654469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in CA · 26160
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
5601 DE SOTO AVE, Woodland Hills, CA 91367

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peter Wibisono Pt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Peter Wibisono reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Maintenance Organization
5601 DE SOTO AVE
Woodland Hills, CA 91367
  • Reassigned Medicare billing, California enrollment
  • 13,921 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist (Orthopedic)
5601 DE SOTO AVE, PHYSICAL THERAPY DEPARTMENT
WOODLAND HILLS, CA 91367
Technician, Other
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367
Anesthesiology
5601 DE SOTO AVE, DEPT OF ANESTHESIA
WOODLAND HILLS, CA 91367
Nurse Anesthetist, Certified Registered
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367
Advanced Practice Midwife
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367
Surgery (Surgical Oncology)
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367
Pediatrics (Pediatric Infectious Diseases)
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367
Physician Assistant
5601 DE SOTO AVE
WOODLAND HILLS, CA 91367

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 Peter Wibisono's NPI number?

The NPI number for Peter Wibisono is 1366654469. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Where is Peter Wibisono located?

Peter Wibisono practices at 5601 De Soto Ave, Woodland Hills, CA 91367. The listed phone number is (818) 719-2773.

What is Peter Wibisono's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Peter Wibisono enrolled in Medicare?

Yes. Peter Wibisono is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Peter Wibisono's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Wibisono reassigns Medicare benefits to Southern California Permanente Medical Group (Woodland Hills, 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 Peter Wibisono'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 Peter Wibisono was last updated on January 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.