Individual provider Active NPI

Thanit Noom Sirimaturos, PT, DPT, FAAOMPT

  • Orthopedic Physical Therapist
  • Palo Alto, CA
National Provider Identifier
1407107238
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
39389 Issued in CA
Practice address
3825 El Camino Real
Palo Alto, CA 94306-3324
Phone
(650) 565-8090
NPI assigned
Sep 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39389 CA
Sports Physical Therapist 2251S0007X 39389 CA
Orthopedic Physical Therapist 2251X0800X 39389 CA Primary

Addresses

Primary practice location

3825 El Camino Real
Palo Alto, CA 94306-3324

Mailing address

4038 Fitzpatrick Way
Santa Clara, CA 95054-4194
Phone (626) 922-7139

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140602002243 CA Practitioner - Physical Therapist in Private Practice 5193948685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agile Physical Therapy IncGroup PAC ID 2163311556, 48 clinicians

Practice addresses (Care Compare)

3825 El Camino Real
Palo Alto, CA 94306-3324
Phone (650) 565-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39389CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Agile Physical Therapy Inc CurrentSince Dec 1, 2022 Accepting new patients
Goodman Physical Therapy Physical Therapist PastSince Mar 7, 2019 Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2001 S Barrington Ave
Ste 119
Los Angeles, CA 90025
Phone (310) 441-1102

3825 El Camino Real
Palo Alto, CA 94306
Phone (856) 296-2860

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

801 N San Mateo Dr
San Mateo, CA 94401

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1407107238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4038 FITZPATRICK WAY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950544194",
            "telephone_number": "626-922-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943063324",
            "telephone_number": "650-565-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIMATUROS",
        "first_name": "THANIT",
        "middle_name": "NOOM",
        "credential": "PT, DPT, FAAOMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-19",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39389",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "39389",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.