Active NPI
Edward Michael De Leon, DC, ATC, CMT
- Massage Therapist
- San Jose, CA
National Provider Identifier
1538820113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 42341
- Practice address
- 3033 Harvestwood CT
San Jose, CA 95148-2704 - Phone
- (408) 677-7518
- NPI assigned
- Jan 5, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000030720 | CA | |
| Massage Therapist | 225700000X | 42341 | CA | Primary |
Addresses
Primary practice location
3033 Harvestwood CT
San Jose, CA 95148-2704
Mailing address
3033 Harvestwood CT
San Jose, CA 95148-2704
Phone (408) 677-7518
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 |
|---|---|---|---|
| 42341 | CA | MD | Physical Therapist |
| 2000030720 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1538820113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 HARVESTWOOD CT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951482704",
"telephone_number": "408-677-7518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 HARVESTWOOD CT",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951482704",
"telephone_number": "408-677-7518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "EDWARD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC, ATC, CMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-05",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "2000030720",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "42341",
"primary": true
}
],
"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 Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.