Active NPI
Jared Loey
- Physical Therapy Assistant
- Greenbrae, CA
National Provider Identifier
1790340941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 47949
- Practice address
- 1220 S Eliseo Dr
Greenbrae, CA 94904-2006 - Phone
- (415) 461-9700
- NPI assigned
- May 2, 2019
- 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 Therapy Assistant | 225200000X | 47949 | CA | Primary |
Addresses
Primary practice location
1220 S Eliseo Dr
Greenbrae, CA 94904-2006
Mailing address
4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47949 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556755200000",
"number": "1790340941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY STE 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972224628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 S ELISEO DR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042006",
"telephone_number": "415-461-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOEY",
"first_name": "JARED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-02",
"last_updated": "2019-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "47949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.