Individual provider Active NPI

Laetitia Le Roux, PT

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1245794965
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296192 Issued in CA
Practice address
2680 S White Rd Ste 200
San Jose, CA 95148-2079
Phone
(408) 274-0888
Fax
(408) 274-2858
NPI assigned
Jan 27, 2019
Last updated
Jan 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

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 296192 CA Primary

Addresses

Primary practice location

2680 S White Rd Ste 200
San Jose, CA 95148-2079

Mailing address

2680 S White Rd Ste 200
San Jose, CA 95148-2079
Phone (408) 274-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925002124 CA Practitioner - Physical Therapist in Private Practice 0244560787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imotion Physical Therapy, IncGroup PAC ID 2163585209, 22 clinicians

Practice addresses (Care Compare)

730 Empey Way
San Jose, CA 95128-4705
Phone (408) 275-1500

Merit-based Incentive Payment System (MIPS)

Final score
90.96 of 100Reported as group
Quality
85
Improvement activities
40
Cost
73.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Imotion Physical Therapy, Inc Physical Therapist CurrentSince Jun 9, 2019 Accepting new patients
Omega Sports Rehabilitation, Inc. Physical Therapist CurrentSince Jun 9, 2019 Accepting new patients
Golden Hills Orthopedic and Sports Physical Therapy Inc. Physical Therapist PastSince Apr 15, 2013 Accepting new patients
Golden Hills Orthopedic and Sports Physical Therapy Inc. Physical Therapist Past Accepting new patients

Locations

39120 Argonaut Way
Fremont, CA 94538
Phone (510) 796-0770

555 Mowry Ave
Ste E
Fremont, CA 94536
Phone (510) 745-7000

14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone (408) 358-3631

14981 National Ave
Ste 102
Los Gatos, CA 95032

730 Empey Way
San Jose, CA 95128
Phone (408) 275-1500

Organizations & group practices 4

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": "1548547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1245794965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482079",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482079",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE ROUX",
        "first_name": "LAETITIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-27",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296192",
            "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 Jan 27, 2019; 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.