NPIMap

Organization Active NPI

Evergreen Physical Therapy

  • Physical Therapy Clinic/Center
  • San Jose, CA
National Provider Identifier
1639267438
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
14729 Issued in CA
Legal business name
EVERGREEN PHYSICAL THERAPY
Practice address
1624 E Capitol Expy
San Jose, CA 95121-1800
Phone
(408) 270-2280
Fax
(408) 270-1902
NPI assigned
Oct 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Stuart R Katzman, PTNPI 1275621054
Title
Owner
Phone
(408) 270-2280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 14729 CA Primary

Addresses

Primary practice location

1624 E Capitol Expy
San Jose, CA 95121-1800

Mailing address

1624 E Capitol Expy
San Jose, CA 95121-1800
Phone (408) 270-2280

National Provider Directory

National Provider Directory

Locations

1624 E Capitol Expy
San Jose, CA 95121
Phone (408) 270-2280

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639267438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 E CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211800",
            "telephone_number": "408-270-2280",
            "fax_number": "408-270-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 E CAPITOL EXPY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211800",
            "telephone_number": "408-270-2280",
            "fax_number": "408-270-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KATZMAN",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-270-2280",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "14729",
            "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 Aug 22, 2020; 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.