Organization Active NPI

Cupertino Physical Therapy, Inc

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1184645863
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24482 Issued in CA
Legal business name
CUPERTINO PHYSICAL THERAPY, INC
Practice address
1054 S de Anza Blvd Ste 120
San Jose, CA 95129-3553
Phone
(408) 873-8188
Fax
(408) 873-8138
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Stacy Alvares, PTNPI 1932853124
Title
Physicial Therapist
Phone
(213) 379-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT24482 CA Primary

Addresses

Primary practice location

1054 S de Anza Blvd Ste 120
San Jose, CA 95129-3553

Mailing address

1054 S de Anza Blvd Ste 120
San Jose, CA 95129-3553
Phone (408) 873-8188

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ65626ZOtherCABLUE SHIELD
DE3340OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071119000666 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2567550981 Receives reassigned benefits from 2 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

1054 S De Anza Blvd
Ste 110
San Jose, CA 95129
Phone (408) 873-8188

1054 S De Anza Blvd
Ste 120
San Jose, CA 95129
Phone (408) 257-2225

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1184645863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 S DE ANZA BLVD STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293553",
            "telephone_number": "408-873-8188",
            "fax_number": "408-873-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 S DE ANZA BLVD STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293553",
            "telephone_number": "408-873-8188",
            "fax_number": "408-873-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUPERTINO PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "ALVARES",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PHYSICIAL THERAPIST",
        "authorized_official_telephone_number": "213-379-1700",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65626Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE3340",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.