Individual provider Active NPI

Enrique Cortes Dimas, OTR/L

  • Occupational Therapist
  • San Jose, CA
National Provider Identifier
1194566174
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
26473 Issued in CA
Practice address
5598 Entrada Cedros Ste 10
San Jose, CA 95123-3120
Phone
(408) 268-8536
NPI assigned
Jun 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 26473 CA Primary

Addresses

Primary practice location

5598 Entrada Cedros Ste 10
San Jose, CA 95123-3120

Mailing address

5598 Entrada Cedros Ste 10
San Jose, CA 95123-3120
Phone (408) 268-8536

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809001744 CA Practitioner - Occupational Therapist in Private Practice 2062950967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands-on-CareGroup PAC ID 3971682311, 5 clinicians

Practice addresses (Care Compare)

5598 Entrada Cedros
Suite 10
San Jose, CA 95123-3120
Phone (408) 268-8536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26473CAMDOccupational Therapist

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1194566174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5598 ENTRADA CEDROS STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233120",
            "telephone_number": "408-268-8536",
            "fax_number": "408-268-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5598 ENTRADA CEDROS STE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233120",
            "telephone_number": "408-268-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTES DIMAS",
        "first_name": "ENRIQUE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "26473",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 4, 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.