JACK WEN DUO CHAN-IMAI (DPT) – Physical Therapist, NPI 1295137669

JACK WEN DUO CHAN-IMAI (DPT) is a healthcare provider. based in Diamond bar, California. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. PT 41586 (CA). The NPI Number for JACK WEN DUO CHAN-IMAI (DPT) is 1295137669

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
JACK WEN DUO CHAN-IMAI (DPT)
NPI
1295137669
Phone
(909) 861-3511
Address
21015 Pathfinder Rd Ste 100
Enumeration Date
17 September 2014
Last Update Date
5 November 2020

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
5105471630
Graduation Year
2014 (12 years ago)
PAC ID
1658695234
Group Practice PAC ID
0446146708
Professional Enrollment ID
I20150131000006
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for JACK WEN DUO CHAN-IMAI (DPT)

  • 21015 Pathfinder Rd Ste 100

    Diamond Bar, CA 917654002

    Phone: (909) 861-3511

    Fax: (909) 860-7900

    Type: Location

  • 21015 PATHFINDER RD STE 100

    DIAMOND BAR, CA 917654002

    Phone: (909) 861-3511

    Fax: (909) 860-7900

    Type: Mailing

  • 4341 PIEDMONT AVE STE 201

    OAKLAND, CA 946114792

    Phone: (510) 547-1630

    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: 2015-01-31

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
I20150131000006IPhysical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,24083$0
97530Therapy procedure using functional activities1,18894$0
97140Therapy procedure using manual technique, each 15 minutes971108$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes870103$0
97162Evaluation for physical therapy, typically 30 minutes2120$0
View full utilization report →

Insurance plans in this area (ZIP 91765)

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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: 0446146708View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Can I use this page to confirm JACK WEN DUO CHAN-IMAI (DPT)'s NPI?
Yes. JACK WEN DUO CHAN-IMAI (DPT) is listed with NPI 1295137669 in the public NPI dataset.
Is JACK WEN DUO CHAN-IMAI (DPT) still practicing?
JACK WEN DUO CHAN-IMAI (DPT) is currently listed as active in the public NPI registry.
What is JACK WEN DUO CHAN-IMAI (DPT)'s primary classification?
Physical Therapist is the headline specialty for JACK WEN DUO CHAN-IMAI (DPT) here. Clinical services aligned with this taxonomy classification.
Does JACK WEN DUO CHAN-IMAI (DPT) list a practice location?
Patients near Diamond Bar, California may find JACK WEN DUO CHAN-IMAI (DPT) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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