Active NPI
Jessica Marie Kaltsas, PTA
- Physical Therapy Assistant
- San Jose, CA
National Provider Identifier
1447593744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9391
- Practice address
- 550 S Winchester Blvd
Suite 125
San Jose, CA 95128-2544 - Phone
- (408) 293-7767
- NPI assigned
- Apr 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9391 | CA | Primary |
| Physical Therapy Assistant | 225200000X | 160005564 | IL |
Addresses
Primary practice location
550 S Winchester Blvd
Suite 125
San Jose, CA 95128-2544
Mailing address
5424 Woodhurst LN
San Jose, CA 95123-1351
Phone (847) 567-9694
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9391 | CA | MD | Professional Counselor |
| 160005564 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1447593744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5424 WOODHURST LN",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951231351",
"telephone_number": "847-567-9694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 S WINCHESTER BLVD",
"address_2": "SUITE 125",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282544",
"telephone_number": "408-293-7767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALTSAS",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-04",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "9391",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160005564",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.