Individual provider Active NPI

Mithilesh V Tadepalli

  • Physical Therapist
  • Oakland, CA
National Provider Identifier
1508783473
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
525 12TH St
Oakland, CA 94607-4927
Phone
(800) 607-6377
NPI assigned
Jul 1, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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 CA Primary

Addresses

Primary practice location

525 12TH St
Oakland, CA 94607-4927

Mailing address

280 Fountain Grass Ter
Fremont, CA 94539-8412
Phone (408) 992-1304

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

NPI Registry JSON

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

{
    "created_epoch": "1782864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1508783473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 FOUNTAIN GRASS TER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945398412",
            "telephone_number": "408-992-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 12TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946074927",
            "telephone_number": "800-607-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADEPALLI",
        "first_name": "MITHILESH",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.