PTR Sports, a Medical Corporation

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

PTR SPORTS, A MEDICAL CORPORATION

Practice address

1825 Civic Center Dr
Suite 25
Santa Clara, CA 95050-7301

Phone

(408) 404-4700

Fax

(408) 404-4701

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey G Blue, M.D.

Title

President

Phone

(408) 404-4700

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1775/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jan Kenneth Klofter, P.T.

  • Physical Therapist
  • Santa Clara, CA
  • NPI 1851574289
  NPD (past)
• Madeleine Ma, PA-C

  • Physician Assistant
  • Sunnyvale, CA
  • NPI 1376158907
  NPD (past)
• Joana Yang Sun, FNP-BC

  • Family Nurse Practitioner
  • Rensselaer, NY
  • NPI 1720502693
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1083750764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "address_2": "SUITE 25",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950507301",
            "telephone_number": "408-404-4700",
            "fax_number": "408-404-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 CIVIC CENTER DR",
            "address_2": "SUITE 25",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950507301",
            "telephone_number": "408-404-4700",
            "fax_number": "408-404-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PTR SPORTS, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-404-4700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Elliot Pross, MD
• Prosthetic Solutions, Inc.
• Kimberly Marie Pruett, MD
• Jade Rae Prunella
• Alix J Pruzansky, MD
• Victoria Dasalla Puntanilla, LVN
• Kenneth W. Purdy, MD
• Shawn Matthew Purnell, M.D.
• Purple Star Health & Wellness
• Purpletree LLC

• Sports Medicine (Family Medicine) Physician in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.