Individual provider Active NPI

Koji Okamoto, MPT

  • Physical Therapist
  • Cupertino, CA
National Provider Identifier
1043485592
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34646 Issued in CA
Practice address
21960 McClellan Rd
Cupertino, CA 95014-4058
Phone
(502) 715-2076
NPI assigned
Apr 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048421 NY
Physical Therapist 225100000X PT 012068 OH
Physical Therapist 225100000X 34646 CA Primary

Addresses

Primary practice location

21960 McClellan Rd
Cupertino, CA 95014-4058

Mailing address

21960 McClellan Rd
Cupertino, CA 95014-4058
Phone (650) 271-5207

Other practice location 1

217 Merrick Rd Ste 204
Amityville, NY 11701-3449
Phone (650) 271-5207

Other practice location 2

3441 Alma St
Ste 200
Palo Alto, CA 94306-3506
Phone (650) 323-4440

Other practice location 3

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120416000073 CA Practitioner - Physical Therapist in Private Practice 2860653029 Reassigns benefits to 1 organization
I20220926002093 NY Practitioner - Physical Therapist in Private Practice 2860653029 Reassigns benefits to 2 organizations
Practice locations: Amityville, NY

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34646CAMDClinical Social Worker
PT 012068OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Dec 3, 2018 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist PastSince Apr 6, 2021 Accepting new patients
Jeffrey Edward Poplarski DC LLC PastSince May 1, 2023 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

576 Broadhollow Rd
Melville, NY 11747

121 Broadhollow Rd
Melville, NY 11747
Phone (631) 354-5600

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1043485592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21960 MCCLELLAN RD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144058",
            "telephone_number": "650-271-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21960 MCCLELLAN RD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950144058",
            "telephone_number": "502-715-2076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Merrick Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Amityville",
            "state": "NY",
            "postal_code": "117013449",
            "country_code": "US",
            "telephone_number": "650-271-5207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3441 Alma St",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943063506",
            "country_code": "US",
            "telephone_number": "650-323-4440",
            "fax_number": "650-323-4441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKAMOTO",
        "first_name": "KOJI",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048421",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 012068",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.