Jesse Kusmulyana, PTA
Physical Therapy Assistant · Peridot, AZ
Jesse Kusmulyana, PTA is a physical therapy assistant with a practice address in Peridot, Arizona, and NPI 1467010082, issued on May 29, 2019. Check the license (Arizona PTA-013887, as entered in NPPES) with the Arizona board that licenses this profession; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Jesse Kusmulyana
- Credential
- PTA
- Primary taxonomy
- Physical Therapy Assistant 225200000X
- License number
- PTA-013887 AZ
Self-reported in NPPES; status is on the state search - Practice location
- 103 Medicine Way RD, Peridot, AZ 85542
- Phone
- (928) 475-1360
- Enumerated
- May 29, 2019
- Record last updated
- May 29, 2019 (not updated in 7 years: call before relying on the address or phone)
- Entity
- Type 1 · individual
Also registered at 103 Medicine Way RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Manuel Abeyta, FNP-BCFamily Nurse Practitioner1871323600
- Liliane Abongwa, PHARMD., MBAPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist1689141327
- Jade Abudia, PHARM.D.Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist1356868491
- Fabrice Afanyu-Lorater, RPH.Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist1265929145
- Julius AnumbosiPharmacist1508353301
- Spencer Bigler, FNPFamily Medicine Physician1629710967
Verify Jesse Kusmulyana in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Arizona board licenses this profession
Search for license PTA-013887Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
1 physical therapy assistant records list a practice address in Peridot
They are 1 of the 68 NPPES records with a practice address in Peridot, and 1,023 physical therapy assistant records in Arizona. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
Other physical therapy assistant records in Arizona
- Linda AbeggPhoenix, AZ1184317042
- Vanessa AbrahamsonPhoenix, AZ1659566941
- Lisa Acevedo, PTATempe, AZ1548864135
- Ricky Acevedo, PTAScottsdale, AZ1457799959
- Holly Acosta, PTAPhoenix, AZ1194323311
- Baby Jane AcutinSun City West, AZ1518332485
- Erin Adamczyk, PTAQueen Creek, AZ1104688357
- Gabriel Aguilar, PTAAvondale, AZ1104340264
- Carolina Aguilar Contreras, PTAGoodyear, AZ1932678414
- Ryanne Agustin, PTAScottsdale, AZ1194343889
Common questions
What is Jesse Kusmulyana, PTA's NPI number?
Jesse Kusmulyana, PTA's National Provider Identifier (NPI) is 1467010082, issued on May 29, 2019. An NPI identifies a provider in billing; it is not a license.
Where is Jesse Kusmulyana, PTA located?
The NPPES record lists a practice address at 103 Medicine Way RD, Peridot, AZ, 85542. Phone: (928) 475-1360. Providers update this record themselves, so call before visiting.
How can I verify Jesse Kusmulyana, PTA's license?
NPPES lists Arizona license number PTA-013887, as entered by the provider. Search the Arizona board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.