JARED TAN DICIOCO PT
NPI 1538055181
Physical Therapist - Orthopedic in Los Angeles, CA

Q: What is Jared Dicioco's NPI number?

The NPI number for Jared Dicioco is 1538055181. It was assigned to this individual provider in the NPPES registry on June 17, 2025.

Q: What is Jared Dicioco's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: When was this NPI record last updated?

The NPPES record for Jared Dicioco was last updated on August 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since June 17, 2025Accepts Medicare Assignment

1640 MARENGO ST STE 102, LOS ANGELES, CA 90033(323) 865-1200 Get Directions Write a Review

NPPES record last updated: August 14, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 14, 2025, Jun 24, 2025, Jun 17, 2025 (3 updates tracked since 2025).

On this page

About Jared Tan Dicioco Pt NPPES

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

JARED TAN DICIOCO PT (NPI 1538055181) is an individual orthopedic provider in Los Angeles, California, licensed in California (308208) and active in the NPI registry since June 2025. He is a graduate of Western University Of Health Sciences College Of Dental Med (2025).

NPPES Registry Identity

NPI1538055181

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameJARED TAN DICIOCOCredential: PT

Location Address1640 MARENGO ST STE 102Los Angeles, CA 90033-1061

Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (323) 865-1200

Phone(323) 865-1200

Sole ProprietorYes

Medical School CMSWestern University Of Health Sciences College Of Dental MedGraduated 2025

Enumeration DateJune 17, 2025

Last NPPES UpdateAugust 14, 20253 updates tracked since enumeration

NPPES CertifiedAugust 14, 2025

✔ NPI 1538055181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

License✔ Licensed in CA · 308208

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

1640 MARENGO ST STE 102, Los Angeles, CA 90033

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jared Tan Dicioco Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345755500

PECOS Enrollment IDI20250716000869

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.

DR. DORIAN DANIC D.P.T.

Physical Therapist