Individual provider Active NPI

Sogol N Mazaheri, DPT

  • Physical Therapist
  • Cupertino, CA
National Provider Identifier
1841671963
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42578 Issued in CA
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

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1053320325OtherCAGROUP NPI
ZZZ29361ZOtherCAGROUP 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

LicenseStateTypeSpecialty
42578CAMDPhysical 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.

Verify at the official NPI Registry.