Active NPI
Sogol N Mazaheri, DPT
- Physical Therapist
- Cupertino, CA
National Provider Identifier
1841671963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 42578
- Practice address
- 20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112 - Phone
- (408) 252-6076
- Fax
- (408) 252-1159
- NPI assigned
- Jun 15, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 42578 | CA | Primary |
Addresses
Primary practice location
20823 Stevens Creek Blvd Ste 200
Cupertino, CA 95014-2112
Mailing address
263 N Mathilda Ave
Sunnyvale, CA 94086-4830
Phone (408) 736-7600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053320325 | Other | CA | GROUP NPI |
| ZZZ29361Z | Other | CA | GROUP MC PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
20823 Stevens Creek Blvd
Suite 200
Cupertino, CA 95014-2108
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42578 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1841671963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 N MATHILDA AVE",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940864830",
"telephone_number": "408-736-7600",
"fax_number": "408-736-7604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20823 STEVENS CREEK BLVD STE 200",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950142112",
"telephone_number": "408-252-6076",
"fax_number": "408-252-1159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZAHERI",
"first_name": "SOGOL",
"middle_name": "N",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-15",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "42578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1053320325",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MC PTAN",
"identifier": "ZZZ29361Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.