Active NPI
Jason Tanaka, PT, DPT
- Physical Therapist
- West Hollywood, CA
National Provider Identifier
1265854137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39899
- Practice address
- 1234 N la Brea Ave
#114
West Hollywood, CA 90038-1179 - Phone
- (213) 841-1946
- NPI assigned
- Jan 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 39899 | CA | Primary |
Addresses
Primary practice location
1234 N la Brea Ave
#114
West Hollywood, CA 90038-1179
Mailing address
1234 N la Brea Ave
#114
West Hollywood, CA 90038-1179
Phone (213) 841-1946
Other practice location 1
68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39899 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Foot and Ankle Institute a Podiatric Surgical Center | Past | 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.
-
- Podiatrist
- Santa Monica, CA
- NPI 1912014986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1265854137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1234 N LA BREA AVE",
"address_2": "#114",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900381179",
"telephone_number": "213-841-1946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 N LA BREA AVE",
"address_2": "#114",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900381179",
"telephone_number": "213-841-1946"
}
],
"practiceLocations": [
{
"address_1": "68 Willow Rd",
"address_purpose": "LOCATION",
"city": "Menlo Park",
"state": "CA",
"postal_code": "940253653",
"country_code": "US",
"telephone_number": "866-839-6979",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANAKA",
"first_name": "JASON",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-13",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.