Individual provider Active NPI

Heidi Akemi Tiglao, PT

  • Physical Therapist
  • Los Gatos, CA
National Provider Identifier
1215792403
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30255 Issued in CA
Practice address
16185 Los Gatos Blvd Ste 205
Los Gatos, CA 95032-4569
Phone
(866) 839-6979
NPI assigned
Feb 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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 30255 CA Primary

Addresses

Primary practice location

16185 Los Gatos Blvd Ste 205
Los Gatos, CA 95032-4569

Mailing address

16185 Los Gatos Blvd Ste 205
Los Gatos, CA 95032-4569
Phone (866) 839-6979

Other names 1

  • Heidi Akemi Ryen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30255CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist PastSince Apr 6, 2021 Accepting new patients

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": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1215792403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16185 LOS GATOS BLVD STE 205",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950324569",
            "telephone_number": "866-839-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16185 LOS GATOS BLVD STE 205",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950324569",
            "telephone_number": "866-839-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIGLAO",
        "first_name": "HEIDI",
        "middle_name": "AKEMI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "30255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "RYEN",
            "middle_name": "AKEMI",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.