NPIMap

Organization Active NPI

Omega Sports Rehabilitation, Inc.

  • Physical Therapy Clinic/Center
  • Los Gatos, CA
National Provider Identifier
1770616161
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OMEGA SPORTS REHABILITATION, INC.
Practice address
14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone
(408) 358-3631
Fax
(408) 358-4537
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Robert Jack
Title
Director Owner
Phone
(408) 358-3631

Specialties & licenses 1

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

Addresses

Primary practice location

14901 National Ave
Ste 102
Los Gatos, CA 95032

Mailing address

14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone (408) 358-3631

Other identifiers 1

IdentifierTypeStateIssuer
239059200OtherDEPT OF LABOR WORKERS COM

National Provider Directory

National Provider Directory

Locations

14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone (408) 358-3631

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1770616161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 NATIONAL AVE",
            "address_2": "STE 102",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-3631",
            "fax_number": "408-358-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 NATIONAL AVE",
            "address_2": "STE 102",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-3631",
            "fax_number": "408-358-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA SPORTS REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "408-358-3631"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORKERS COM",
            "identifier": "239059200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.