Individual provider Active NPI

Thomas H Peck, P.T.

  • Physical Therapist
  • Santa Clara, CA
National Provider Identifier
1053363549
Registry record updated Jun 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 13732 Issued in CA
Practice address
2488 De la Cruz Blvd
Santa Clara, CA 95050-2923
Phone
(408) 274-7278
Fax
(408) 247-9320
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2009

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 PT 13732 CA Primary

Addresses

Primary practice location

2488 De la Cruz Blvd
Santa Clara, CA 95050-2923

Mailing address

246 Sobrante Way
Sunnyvale, CA 94086-4807
Phone (408) 733-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000435 CA Practitioner - Physical Therapist in Private Practice 5193739118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard P Carr Physical Therapy IncGroup PAC ID 9830182070, 28 clinicians

Practice addresses (Care Compare)

500 E Calaveras Blvd
Suite 112
Milpitas, CA 95035-7708
Phone (408) 934-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 13732CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard P Carr Physical Therapy Inc Physical Therapist Current Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist CurrentSince Aug 24, 2008 Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist CurrentSince Aug 24, 2008 Accepting new patients
Richard P. Carr Physical Therapy Inc Physical Therapist Past Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

3395 S Bascom Ave
Ste 140
Campbell, CA 95008
Phone (408) 369-8556

500 E Calaveras Blvd
Ste 112
Milpitas, CA 95035
Phone (408) 733-3670

670 E Calaveras Blvd
Milpitas, CA 95035
Phone (408) 934-4700

605 Tennant Ave
Ste F
Morgan Hill, CA 95037
Phone (408) 778-3434

125 N Jackson Ave
Ste 204
San Jose, CA 95116
Phone (408) 254-7730

2488 De la Cruz Blvd
Santa Clara, CA 95050
Phone (408) 247-7278

246 Sobrante Way
Sunnyvale, CA 94086
Phone (408) 733-3670

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1053363549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SOBRANTE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864807",
            "telephone_number": "408-733-3670",
            "fax_number": "408-245-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 DE LA CRUZ BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950502923",
            "telephone_number": "408-274-7278",
            "fax_number": "408-247-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 13732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.