Individual provider Active NPI

Rebecca Ferguson, DPT

  • Orthopedic Physical Therapist
  • Cupertino, CA
National Provider Identifier
1457507402
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT37052 Issued in CA
Practice address
1601 S de Anza Blvd
Suite 111
Cupertino, CA 95014-5347
Phone
(408) 257-2225
Fax
(408) 257-2485
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 030502-1 NY
Orthopedic Physical Therapist 2251X0800X PT37052 CA Primary

Addresses

Primary practice location

1601 S de Anza Blvd
Suite 111
Cupertino, CA 95014-5347

Mailing address

1601 S de Anza Blvd
Suite 111
Cupertino, CA 95014-5347
Phone (408) 257-2225

Other names 1

  • Rebecca Siedner Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000787 CA Practitioner - Physical Therapist in Private Practice 2567539331 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37052CAMDLicensed Psychiatric Technician
030502-1NYMDPhysical Therapist
PT37052CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Gatos Orthopedic Sports Therapy, Inc. Physical Therapist CurrentSince Nov 1, 2011 Accepting new patients
Permanente Medical Group Inc CurrentSince Jan 5, 2015 Accepting new patients
Permanente Medical Group, Inc CurrentSince Jan 5, 2015 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients
Los Gatos Hand Therapy, LLC PastSince Jun 6, 2021 Accepting new patients

Locations

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

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 6

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": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1457507402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S DE ANZA BLVD",
            "address_2": "SUITE 111",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950145347",
            "telephone_number": "408-257-2225",
            "fax_number": "408-257-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S DE ANZA BLVD",
            "address_2": "SUITE 111",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950145347",
            "telephone_number": "408-257-2225",
            "fax_number": "408-257-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "REBECCA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030502-1",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT37052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "SIEDNER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.