Individual provider Active NPI

John Zdankus, PT, DPT

  • Physical Therapist
  • Saratoga, CA
National Provider Identifier
1104524180
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303766 Issued in CA
Practice address
12930 Saratoga Ave Ste B5
Saratoga, CA 95070-4661
Phone
(408) 973-7700
NPI assigned
Feb 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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 303766 CA Primary

Addresses

Primary practice location

12930 Saratoga Ave Ste B5
Saratoga, CA 95070-4661

Mailing address

19207 Brockton LN
Saratoga, CA 95070-4005
Phone (408) 691-7781

Other identifiers 1

IdentifierTypeStateIssuer
303766MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230308001841 CA Practitioner - Physical Therapist in Private Practice 0941673164 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
Optm Physical Therapy of Saratoga IncGroup PAC ID 7719967272, 13 clinicians

Practice addresses (Care Compare)

12930 Saratoga Ave
Suite B5
Saratoga, CA 95070-4661
Phone (408) 973-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optm Physical Therapy of Saratoga, Inc. Physical Therapist CurrentSince Feb 20, 2023 Accepting new patients

Locations

12930 Saratoga Ave
Ste B5
Saratoga, CA 95070
Phone (408) 763-4905

Organizations & group practices 1

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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1104524180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19207 BROCKTON LN",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704005",
            "telephone_number": "408-691-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12930 SARATOGA AVE STE B5",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704661",
            "telephone_number": "408-973-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDANKUS",
        "first_name": "JOHN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303766",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.