Nathan Wakamoto, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306825 Issued in CA

Practice address

4572 Telephone Rd Ste 903
Ventura, CA 93003-5663

Phone

(805) 654-8127

NPI assigned

Sep 23, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blayne Robinson Liparoto 6 clinicians

Rise Pacific Physical Therapy and Sports Medicine 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blayne Robinson Liparoto

  • Physical Therapy Clinic/Center
  • Ventura, CA
  • NPI 1205878865

  CA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rise Pacific Physical Therapy and Sports Medicine

  • Physical Therapy Clinic/Center
  • Thousand Oaks, CA
  • NPI 1952855843

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1104643089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 TELEPHONE RD STE 903",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035663",
            "telephone_number": "805-654-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 TELEPHONE RD STE 903",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035663",
            "telephone_number": "805-654-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKAMOTO",
        "first_name": "NATHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Elizabeth Wagner, MD
• Stephanie Wagner, OTR/L
• Susan Elizabeth Wagner, M.A., M.F.T.I.
• Samantha Sloan Waid, RN, IBCLC
• Irene Bih Wakam, MD
• Casey Wake, PSY.D.
• Wal-Mart Stores, Inc.
• Matthew Stephen Walden
• Susan Lyn Walin, PA C
• Amy Marie-Hess Walker, L.AC

• All providers in Ventura, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.