NPIMap

Organization Active NPI

Los Gatos Orthopedic Sports Therapy, Inc.

  • Orthopedic Physical Therapist
  • Los Gatos, CA
National Provider Identifier
1366510414
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
22627 Issued in CA
Legal business name
LOS GATOS ORTHOPEDIC SPORTS THERAPY, INC.
Practice address
15100 Los Gatos Blvd
Suite 1
Los Gatos, CA 95032-2028
Phone
(408) 358-1460
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ross M. Nakaji, PT, OCS, SCS, ATC
Title
President, Ceo, PT
Phone
(408) 358-1460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X 22627 CA Primary

Addresses

Primary practice location

15100 Los Gatos Blvd
Suite 1
Los Gatos, CA 95032-2028

Mailing address

15100 Los Gatos Blvd
Los Gatos, CA 95032-2028
Phone (408) 358-1460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071009000801 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153417951 Receives reassigned benefits from 12 practitioners
Practice locations: Los Gatos, CA

National Provider Directory

National Provider Directory

Locations

16615 Lark Ave
Ste 101
Los Gatos, CA 95032
Phone (408) 358-1460

15100 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 356-0270

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366510414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15100 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322028",
            "telephone_number": "408-358-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15100 LOS GATOS BLVD",
            "address_2": "SUITE 1",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322028",
            "telephone_number": "408-358-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS GATOS ORTHOPEDIC SPORTS THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAKAJI",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT, CEO, PT",
        "authorized_official_telephone_number": "408-358-1460",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, OCS, SCS, ATC"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "22627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.