Active NPI
Kinshoo Tyagi, DPT
- Pediatric Physical Therapist
- Palo Alto, CA
National Provider Identifier
1629349832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT 37316
- Practice address
- 725 Welch Rd
Palo Alto, CA 94304-1601 - Phone
- (650) 497-8665
- NPI assigned
- Jan 19, 2012
- Last updated
- Apr 30, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT 37316 | CA | Primary |
Addresses
Primary practice location
725 Welch Rd
Palo Alto, CA 94304-1601
Mailing address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053305 | Medicaid | CA |
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 |
|---|---|---|---|
| PT 37316 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1629349832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 WELCH RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041601",
"telephone_number": "650-497-8665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYAGI",
"first_name": "KINSHOO",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "PT 37316",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "053305",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.