Individual provider Active NPI

Gregory Ohanessian, PT, DPT

  • Physical Therapist
  • Portola Valley, CA
National Provider Identifier
1306139209
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37823 Issued in CA
Practice address
150 Portola Rd
Portola Valley, CA 94028-7852
Phone
(650) 851-1145
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapist 225100000X 37823 CA Primary

Addresses

Primary practice location

150 Portola Rd
Portola Valley, CA 94028-7852

Mailing address

166 Springfield Dr.
San Francisco, CA 94132
Phone (415) 420-7623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110803000344 CA Practitioner - Physical Therapist in Private Practice 1355510694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37823CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ohanessian Physical Therapy Inc. CurrentSince Apr 20, 2025 Accepting new patients
Pacific Therx Past Accepting new patients
Lisa Green Physical Therapy, PC PastSince Apr 6, 2023 Accepting new patients

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1306139209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 SPRINGFIELD DR.",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94132",
            "telephone_number": "415-420-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PORTOLA RD",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287852",
            "telephone_number": "650-851-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHANESSIAN",
        "first_name": "GREGORY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.