Active NPI
Sue D Edelstein, PT
- Physical Therapist
- Oakland, CA
National Provider Identifier
1679632715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13196
- Practice address
- 275 W Macarthur
Oakland, CA 94611-5641 - Phone
- (510) 752-1000
- Fax
- (510) 752-7578
- NPI assigned
- Dec 6, 2006
- Last updated
- Oct 9, 2014
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 13196 | CA | Primary |
Addresses
Primary practice location
275 W Macarthur
Oakland, CA 94611-5641
Mailing address
275 W Macarthur
Oakland, CA 94611-5641
Phone (510) 752-1000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13196 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412812800000",
"number": "1679632715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W MACARTHUR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115641",
"telephone_number": "510-752-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W MACARTHUR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115641",
"telephone_number": "510-752-1000",
"fax_number": "510-752-7578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELSTEIN",
"first_name": "SUE",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2014-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "13196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.