Individual provider Active NPI

Pardis Esmaeili-Firidouni, DPT

  • Physical Therapist
  • Berkeley, CA
National Provider Identifier
1619514221
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297478 Issued in CA
Practice address
2000 Center St Ste 300
Berkeley, CA 94704-1223
Phone
(510) 644-3031
NPI assigned
Dec 2, 2019
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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 297478 CA Primary

Addresses

Primary practice location

2000 Center St Ste 300
Berkeley, CA 94704-1223

Mailing address

636 14TH St
San Francisco, CA 94114-1309
Phone (949) 400-2140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812001735 CA Practitioner - Physical Therapist in Private Practice 0446676167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Lyon-Martin Community Health ServicesGroup PAC ID 6103203930, 19 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

1735 Mission St
San Francisco, CA 94103-2417
Phone (415) 565-7667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
297478CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyon-Martin Community Health Services CurrentSince Nov 28, 2023 Accepting new patients
Pardis Esmaeili-Firidouni Current Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Aug 9, 2021 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1619514221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 14TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141309",
            "telephone_number": "949-400-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTER ST STE 300",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041223",
            "telephone_number": "510-644-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESMAEILI-FIRIDOUNI",
        "first_name": "PARDIS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.