NPIMap

Organization Active NPI

Vibrantcare Outpatient Rehabilitation of California Inc

Doing business as VibrantCare Outpatient Rehabilitation

  • Physical Therapy Clinic/Center
  • Los Gatos, CA
National Provider Identifier
1154325769
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC
Doing business as
VibrantCare Outpatient Rehabilitation
Practice address
15215 National Ave Ste 100
Los Gatos, CA 95032-2425
Phone
(408) 356-1990
Fax
(408) 356-9981
NPI assigned
Jun 10, 2005
Last updated
Nov 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Mr. David Smith
Title
Ceo
Phone
(916) 782-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

15215 National Ave Ste 100
Los Gatos, CA 95032-2425

Mailing address

PO Box 840343
Los Angeles, CA 90084-0343
Phone (916) 789-8115

Other names 1

  • VibrantCare Outpatient Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20020926000009 CA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 9234046962 Practice locations: Los Gatos, CA; Santa Cruz, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154325769. Details of each certification follow.

  • CCN 056693 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 056693

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VIBRANTCARE REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Dec 1, 1993
Last certification
Jun 18, 2014
Ownership / control type
Proprietary
Facility address
15215 National Avenue, Suite 100
Los Gatos, CA 95032

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Vibrantcare Outpatient Rehabilitation Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

15215 National Ave
Ste 100
Los Gatos, CA 95032
Phone (408) 356-1990

15251 National Ave
Ste 203
Los Gatos, CA 95032
Phone (408) 356-1990

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1154325769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840343",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840343",
            "telephone_number": "916-789-8115",
            "fax_number": "916-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 NATIONAL AVE STE 100",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322425",
            "telephone_number": "408-356-1990",
            "fax_number": "408-356-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANTCARE OUTPATIENT REHABILITATION OF CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-782-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VibrantCare Outpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VibrantCare Outpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.