MR. KENNY LUC (DPT) – Physical Therapist, NPI 1134612674

MR. KENNY LUC (DPT) is a healthcare provider. based in Huntington park, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 291381 (CA). The NPI Number for MR. KENNY LUC (DPT) is 1134612674

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
MR. KENNY LUC (DPT)
NPI
1134612674
Phone
(310) 491-7080
Address
5900 Pacific Blvd
Enumeration Date
9 June 2018
Last Update Date
7 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
81889422731025
Graduation Year
2015 (11 years ago)
PAC ID
7012443062
Group Practice PAC ID
5890972335
Professional Enrollment ID
I20241213000870
Address ID
CA917232791CO599XXAVEX401
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for MR. KENNY LUC (DPT)

  • 5900 Pacific Blvd

    Huntington Park, CA 902552914

    Phone: (310) 491-7080

    Type: Location

  • Lafayette Street, San Gabriel, Los Angeles County, California, 91776, United States

    SAN GABRIEL, CA 917763303

    Phone:

    Type: Mailing

  • 599 S BARRANCA AVE STE 555

    COVINA, CA 917232791

    Phone: (818) 894-2273

    Fax: (818) 357-2505

    Type: Location

  • 5900, Pacific Boulevard, Huntington Park, Los Angeles County, California, 90255, United States

    HUNTINGTON PARK, CA 902552914

    Phone: (310) 491-7080

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241213000870IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90255)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5890972335View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Qualified Speech Language PathologistAZ
Physical Therapist In Private PracticeCA
Qualified Speech Language PathologistTX
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticePA
Qualified Speech Language PathologistFL

Reviews

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Frequently asked questions

Is there an official ID for MR. KENNY LUC (DPT) in U.S. healthcare records?
The official identifier for MR. KENNY LUC (DPT) is NPI 1134612674.
Is MR. KENNY LUC (DPT) still an active registrant?
MR. KENNY LUC (DPT) carries an active NPI according to the public dataset.
What area of care is associated with MR. KENNY LUC (DPT)?
MR. KENNY LUC (DPT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with MR. KENNY LUC (DPT)?
Directory geography for MR. KENNY LUC (DPT) centers on Huntington Park, California.
Does MR. KENNY LUC (DPT) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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