Individual provider Active NPI

Lindsay Nicole Athan, PT, DPT

  • Physical Therapist
  • Dublin, CA
National Provider Identifier
1063719664
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 37424 Issued in CA
Practice address
7080 Donlon Way
Suite 108
Dublin, CA 94568-2787
Phone
(925) 556-4310
Fax
(925) 556-0375
NPI assigned
Feb 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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 37424 CA Primary

Addresses

Primary practice location

7080 Donlon Way
Suite 108
Dublin, CA 94568-2787

Mailing address

7080 Donlon Way
Suite 108
Dublin, CA 94568-2787
Phone (925) 556-4310

Other practice location 1

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000682 CA Practitioner - Physical Therapist in Private Practice 7012190259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37424CAMDLicensed Psychiatric Technician
PT 37424CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Edge PT, Inc. CurrentSince May 17, 2020 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 8, 2019 Accepting new patients

Locations

7080 Donlon Way
Ste 108
Dublin, CA 94568
Phone (925) 556-4310

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

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

Organizations & group practices 2

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": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1063719664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 DONLON WAY",
            "address_2": "SUITE 108",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682787",
            "telephone_number": "925-556-4310",
            "fax_number": "925-556-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DONLON WAY",
            "address_2": "SUITE 108",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682787",
            "telephone_number": "925-556-4310",
            "fax_number": "925-556-0375"
        }
    ],
    "practiceLocations": [
        {
            "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": "ATHAN",
        "first_name": "LINDSAY",
        "middle_name": "NICOLE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 37424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.