Active NPI
Diron Reese Cassidy, M.P.T.
- Physical Therapist
- San Jose, CA
National Provider Identifier
1790080737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26803
- Practice address
- 3150 Almaden Expy
Suite 120
San Jose, CA 95118-1260 - Phone
- (408) 540-7622
- Fax
- (408) 540-7696
- NPI assigned
- Jan 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 26803 | CA | Primary |
Addresses
Primary practice location
3150 Almaden Expy
Suite 120
San Jose, CA 95118-1260
Mailing address
3150 Almaden Expy
Suite 120
San Jose, CA 95118-1260
Phone (408) 540-7622
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 |
|---|---|---|---|
| 26803 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485993600000",
"number": "1790080737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 ALMADEN EXPY",
"address_2": "SUITE 120",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951181260",
"telephone_number": "408-540-7622",
"fax_number": "408-540-7696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 ALMADEN EXPY",
"address_2": "SUITE 120",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951181260",
"telephone_number": "408-540-7622",
"fax_number": "408-540-7696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "DIRON",
"middle_name": "REESE",
"name_prefix": "Mr.",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-24",
"last_updated": "2017-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "26803",
"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 Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.