Jesse Kusmulyana, PTA
NPI 1467010082 · Physical Therapy Assistant · Peridot, AZ
Jesse Kusmulyana, PTA is a Physical Therapy Assistant provider in Peridot, AZ (NPI 1467010082).
Provider details
- NPI number
- 1467010082
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- License
- PTA-013887 (AZ)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-05-29
- Last updated
- 2019-05-29
Frequently asked questions
- What is Jesse Kusmulyana's NPI number?
- Jesse Kusmulyana's National Provider Identifier (NPI) is 1467010082, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jesse Kusmulyana's specialty?
- Jesse Kusmulyana is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Jesse Kusmulyana located?
- Jesse Kusmulyana's practice location on file with NPPES is 103 Medicine Way Rd, Peridot, AZ 85542-5000.
- What is Jesse Kusmulyana's phone number?
- The practice phone number listed in the NPPES registry for Jesse Kusmulyana is (928) 475-1360.
- Is Jesse Kusmulyana's NPI active?
- Yes — Jesse Kusmulyana's NPI (1467010082) is active in the NPPES registry as of the last update on 2019-05-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.