Individual provider Active NPI

Khashayar Yousefian

  • Physical Therapist
  • Sunnyvale, CA
National Provider Identifier
1003525270
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306353 Issued in CA
Practice address
401 Old San Francisco Rd
Sunnyvale, CA 94086-6387
Phone
(408) 523-3060
NPI assigned
Nov 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 306353 CA Primary

Addresses

Primary practice location

401 Old San Francisco Rd
Sunnyvale, CA 94086-6387

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221201000287 NY Practitioner - Physical Therapist in Private Practice 1456729151 Reassigns benefits to 1 organization
I20241003003347 CA Practitioner - Physical Therapist in Private Practice 1456729151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1085 W El Camino Real
Sunnyvale, CA 94087-1030
Phone (408) 524-5900

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

401 Old San Francisco Rd
Sunnyvale, CA 94086-6387
Phone (408) 739-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306353CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Physical Therapy, PLLC Physical Therapist CurrentSince Nov 14, 2022 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 23, 2024 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 23, 2024 Accepting new patients

Locations

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

350 John Muir Pkwy
Ste 160
Brentwood, CA 94513
Phone (925) 204-1920

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 780-0110

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488

401 Old San Francisco Rd
Sunnyvale, CA 94086
Phone (408) 523-3060

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

1317 3rd Ave
Fl 9
New York, NY 10021
Phone (212) 439-1596

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1003525270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OLD SAN FRANCISCO RD",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866387",
            "telephone_number": "408-523-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUSEFIAN",
        "first_name": "KHASHAYAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-16",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.