Active NPI
Edward A Sporbert, M.P.T.
- Physical Therapist
- San Francisco, CA
National Provider Identifier
1275860496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26193
- Practice address
- 1661 Pine Street
San Francisco, CA 94109 - Phone
- (971) 206-5200
- Fax
- (971) 206-5203
- NPI assigned
- Nov 9, 2009
- 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 | 26193 | CA | Primary |
Addresses
Primary practice location
1661 Pine Street
San Francisco, CA 94109
Mailing address
4560 SE International Way
Ste 100
Milwaukie, OR 97222
Phone (971) 206-5200
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 |
|---|---|---|---|
| 26193 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucas Physical Therapy and Fitness Inc | Physical Therapist | 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.
-
- Physical Therapy Clinic/Center
- Sunnyvale, CA
- NPI 1154377596
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257724800000",
"number": "1275860496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 PINE STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94109",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPORBERT",
"first_name": "EDWARD",
"middle_name": "A",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-09",
"last_updated": "2009-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "26193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.