Individual provider Active NPI

Nancy Michie Okumura

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1134265200
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11303 Issued in CA
Practice address
350 Saint Josephs Ave
San Francisco, CA 94115-3255
Phone
(415) 833-4683
NPI assigned
Jan 29, 2007
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 11303 CA Primary

Addresses

Primary practice location

350 Saint Josephs Ave
San Francisco, CA 94115-3255

Mailing address

1635 Divisadero St Ste 300
San Francisco, CA 94115-3043
Phone (415) 833-4683

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121212000456 CA Practitioner - Physical Therapist in Private Practice 7517119860 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Nov 9, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 9, 2011 Accepting new patients

Locations

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

1635 Divisadero St
Ste 300
San Francisco, CA 94115
Phone (415) 833-4325

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

350 Saint Josephs Ave
San Francisco, CA 94115
Phone (415) 833-3870

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

3975 Old Redwood Hwy
Santa Rosa, CA 95403
Phone (707) 393-4000

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1134265200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST STE 300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153043",
            "telephone_number": "415-833-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SAINT JOSEPHS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153255",
            "telephone_number": "415-833-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUMURA",
        "first_name": "NANCY",
        "middle_name": "MICHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "11303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3975 Old Redwood Hwy",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954031719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.