Individual provider Active NPI

Tara Naomi Oyasato, DPT

  • Orthopedic Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1770254906
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
4656 Issued in NV
Practice address
6040 S Rainbow Blvd Ste B1
Las Vegas, NV 89118-2542
Phone
(702) 876-9737
NPI assigned
Sep 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 4656 NV Primary

Addresses

Primary practice location

6040 S Rainbow Blvd Ste B1
Las Vegas, NV 89118-2542

Mailing address

8765 Stella Nova St
Las Vegas, NV 89139-7240
Phone (808) 271-7633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218001031 NV Practitioner - Physical Therapist in Private Practice 9830619196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Condition LLCGroup PAC ID 6204885841, 6 clinicians

Practice addresses (Care Compare)

6040 S Rainbow Blvd
Suite B1
Las Vegas, NV 89118-2542
Phone (702) 876-9737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4656NVMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Condition LLC CurrentSince Jan 1, 2025 Accepting new patients
Peak Condition, LLC PastSince Oct 5, 2021 Accepting new patients

Locations

7250 Peak Dr
Ste 200B
Las Vegas, NV 89128
Phone (702) 876-9737

6040 S Rainbow Blvd
Ste B1
Las Vegas, NV 89118
Phone (702) 876-9737

7250 Peak Dr
Ste 212
Las Vegas, NV 89128

Organizations & group practices 2

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": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1770254906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 STELLA NOVA ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397240",
            "telephone_number": "808-271-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 S RAINBOW BLVD STE B1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891182542",
            "telephone_number": "702-876-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYASATO",
        "first_name": "TARA",
        "middle_name": "NAOMI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NV",
            "license": "4656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.