Individual provider Active NPI

Aaron John Neibel, P.T.A., CSCS

  • Physical Therapy Assistant
  • San Jose, CA
National Provider Identifier
1588794440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 5227 Issued in CA
Practice address
455 Oconnor Dr
San Jose, CA 95128-1633
Phone
(408) 293-7767
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 5227 CA Primary

Addresses

Primary practice location

455 Oconnor Dr
San Jose, CA 95128-1633

Mailing address

1958 Kirby Way
San Jose, CA 95124-1324
Phone (408) 313-4846

Other identifiers 2

IdentifierTypeStateIssuer
200013310OtherCACSCS
AT 5227OtherCAP.T. ASSISTANT

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

LicenseStateTypeSpecialty
AT 5227CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588794440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 KIRBY WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951241324",
            "telephone_number": "408-313-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281633",
            "telephone_number": "408-293-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIBEL",
        "first_name": "AARON",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "P.T.A., CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 5227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSCS",
            "identifier": "200013310",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P.T. ASSISTANT",
            "identifier": "AT 5227",
            "state": "CA"
        }
    ],
    "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 Jul 8, 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.