Individual provider Active NPI

Adam J Javate, PT, DPT

  • Physical Therapist
  • Henderson, NV
National Provider Identifier
1275908857
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4349 Issued in NV
Practice address
10895 S Eastern Ave Ste 120
Henderson, NV 89052-5852
Phone
(725) 204-1016
Fax
(725) 204-6572
NPI assigned
Dec 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 43315 CA
Physical Therapist 225100000X 4349 NV Primary

Addresses

Primary practice location

10895 S Eastern Ave Ste 120
Henderson, NV 89052-5852

Mailing address

10895 S Eastern Ave Ste 120
Henderson, NV 89052-5852
Phone (725) 204-1016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113001588 NV Practitioner - Physical Therapist in Private Practice 3678871373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10895 S Eastern Ave
Suite 120
Henderson, NV 89052-5852
Phone (725) 204-1016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43315CAMDPharmacist
4349NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Fitness Inc Physical Therapist CurrentSince Oct 13, 2020 Accepting new patients
Align Physical Therapy Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Executive Fitness Inc PastSince Sep 20, 2020 Accepting new patients

Locations

10895 S Eastern Ave
Ste 120
Henderson, NV 89052
Phone (725) 204-1016

6440 Medical Center St
Ste 100
Las Vegas, NV 89148
Phone (702) 222-1000

Organizations & group practices 3

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": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1275908857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10895 S EASTERN AVE STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525852",
            "telephone_number": "725-204-1016",
            "fax_number": "725-204-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10895 S EASTERN AVE STE 120",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525852",
            "telephone_number": "725-204-1016",
            "fax_number": "725-204-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVATE",
        "first_name": "ADAM",
        "middle_name": "J",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-07",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "43315",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; 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.