Individual provider Active NPI

Nicholas Arthur Egan, PT

  • Physical Therapist
  • Folsom, CA
National Provider Identifier
1437363520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33579 Issued in CA
Practice address
1301 E Bidwell
Folsom, CA 95630
Phone
(916) 983-5900
Fax
(916) 983-5913
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 33579 CA Primary

Addresses

Primary practice location

1301 E Bidwell
Folsom, CA 95630

Mailing address

1301 E Bidwell St
Suite 201
Folsom, CA 95630
Phone (916) 983-5915

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081015000444 CA Practitioner - Physical Therapist in Private Practice 2860550100 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33579CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince May 20, 2021 Accepting new patients
Burger Rehabilitation Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Organizations & group practices 2

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437363520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL ST",
            "address_2": "SUITE 201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-983-5915",
            "fax_number": "916-983-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-983-5900",
            "fax_number": "916-983-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "NICHOLAS",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.