MR. LOREN KODA KIMBLE (PT) – Physical Therapist, NPI 1336473362

MR. LOREN KODA KIMBLE (PT) is a healthcare provider. based in Petaluma, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT35941 (CA). The NPI Number for MR. LOREN KODA KIMBLE (PT) is 1336473362

Main info

Male
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
MR. LOREN KODA KIMBLE (PT)
NPI
1336473362
Phone
(707) 981-8604
Address
1600 CORPORATE CIR
Enumeration Date
23 September 2009
Last Update Date
9 March 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7079818604
Graduation Year
2009 (17 years ago)
PAC ID
0042409039
Group Practice PAC ID
6103102884
Professional Enrollment ID
I20170412000253
Address ID
CA949547102PE1372XBLVD401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

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Provider Addresses for MR. LOREN KODA KIMBLE (PT)

  • 1600, Corporate Circle, Petaluma, Sonoma County, California, 94954, United States

    PETALUMA, CA 949546912

    Phone: (707) 981-8604

    Fax: (707) 981-8647

    Mailing address matches the actual address.

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: 2017-04-12

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
I20170412000253IPhysical 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
97140Therapy procedure using manual technique, each 15 minutes1,37284$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes1,14475$0
97530Therapy procedure using functional activities27841$0
97535Training for self-care or home management, each 15 minutes14751$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes11633$0
View full utilization report →

Insurance plans in this area (ZIP 94954)

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Provider's Procedures

MR. LOREN KODA KIMBLE (PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCA97001Physical therapy evaluation9290
PHYSICAL THERAPYCA97535Self-care or home management training, each 15 minutes2423

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: 6103102884View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA

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Frequently asked questions

What is the 10-digit NPI for MR. LOREN KODA KIMBLE (PT)?
MR. LOREN KODA KIMBLE (PT) — NPI 1336473362 — is the standard way to identify this listing.
Is MR. LOREN KODA KIMBLE (PT) listed as active for patients and plans?
The listing shows MR. LOREN KODA KIMBLE (PT) as active in the NPI system.
What is MR. LOREN KODA KIMBLE (PT)'s primary classification?
Physical Therapist is the headline specialty for MR. LOREN KODA KIMBLE (PT) here. Clinical services aligned with this taxonomy classification.
What address line appears for MR. LOREN KODA KIMBLE (PT)?
MR. LOREN KODA KIMBLE (PT)'s geographic hint is Petaluma, California in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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