Individual provider Active NPI

Adriane E Costa, PT

  • Physical Therapist
  • Walnut Creek, CA
National Provider Identifier
1699070623
Registry record updated Jan 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33222 Issued in CA
Practice address
101 Ygnacio Valley Rd
Suite 400
Walnut Creek, CA 94596-4087
Phone
(925) 944-0110
Fax
(925) 944-0960
NPI assigned
Jan 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2011

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 33222 CA Primary

Addresses

Primary practice location

101 Ygnacio Valley Rd
Suite 400
Walnut Creek, CA 94596-4087

Mailing address

1874 Tice Valley Blvd
Walnut Creek, CA 94595-2224
Phone (925) 935-0510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130618000012 CA Practitioner - Physical Therapist in Private Practice 1355580630 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33222CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 4, 2024 Accepting new patients
Tice Valley Physcial Therapy Inc. Past Accepting new patients
Tice Valley Physical Therapy and Sports Medicine Inc. Physical Therapist Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295740800000",
    "number": "1699070623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1874 TICE VALLEY BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952224",
            "telephone_number": "925-935-0510",
            "fax_number": "925-935-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 YGNACIO VALLEY RD",
            "address_2": "SUITE 400",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964087",
            "telephone_number": "925-944-0110",
            "fax_number": "925-944-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "ADRIANE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-23",
        "last_updated": "2011-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.