NPIMap

Organization Active NPI

Broberg Physical Therapy

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1528170669
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BROBERG PHYSICAL THERAPY
Practice address
6055 Meridian Ave
Suite 110
San Jose, CA 95120
Phone
(408) 927-0871
Fax
(408) 927-0891
NPI assigned
Aug 31, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Mr. Wayne A Broberg, MPTNPI 1982793477
Title
Owner-Physical Therapist
Phone
(408) 927-0871

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

6055 Meridian Ave
Suite 110
San Jose, CA 95120

Mailing address

6055 Meridian Ave
Suite 110
San Jose, CA 95120
Phone (408) 927-0871

National Provider Directory

National Provider Directory

Locations

6055 Meridian Ave
Ste 110
San Jose, CA 95120
Phone (408) 927-0871

6065 Meridian Ave
Ste 70
San Jose, CA 95120
Phone (408) 927-0871

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1528170669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 MERIDIAN AVE",
            "address_2": "SUITE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95120",
            "telephone_number": "408-927-0871",
            "fax_number": "408-927-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 MERIDIAN AVE",
            "address_2": "SUITE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95120",
            "telephone_number": "408-927-0871",
            "fax_number": "408-927-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROBERG PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "BROBERG",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER-PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "408-927-0871",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "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 Oct 16, 2007; 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.