Individual provider Active NPI

Abraham Mauricio Ramirez Gomez

  • Physical Therapy Assistant
  • San Jose, CA
National Provider Identifier
1578091187
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
1267 Meridian Ave
San Jose, CA 95125-5210
Phone
(408) 265-4211
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X CA Primary

Addresses

Primary practice location

1267 Meridian Ave
San Jose, CA 95125-5210

Mailing address

315 N Avon St
Burbank, CA 91505-3504

Other practice location 1

14500 Fruitvale Ave
Saratoga, CA 95070-6165
Phone (408) 741-7100

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578091187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N AVON ST",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915053504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255210",
            "telephone_number": "408-265-4211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14500 Fruitvale Ave",
            "address_purpose": "LOCATION",
            "city": "Saratoga",
            "state": "CA",
            "postal_code": "950706165",
            "country_code": "US",
            "telephone_number": "408-741-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMIREZ GOMEZ",
        "first_name": "ABRAHAM",
        "middle_name": "MAURICIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": null,
            "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 Mar 17, 2018; 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.