Active NPI
Justine Ekdawy
- Physical Therapist
- Menlo Park, CA
National Provider Identifier
1851998496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 299136
- Practice address
- 3532 Alameda de Las Pulgas
Menlo Park, CA 94025-6510 - Phone
- (650) 561-9589
- NPI assigned
- Oct 7, 2020
- 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 | 299136 | CA | Primary |
Addresses
Primary practice location
3532 Alameda de Las Pulgas
Menlo Park, CA 94025-6510
Mailing address
2820 Wakefield Dr
Belmont, CA 94002-2935
Phone (530) 713-0137
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1851998496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 WAKEFIELD DR",
"city": "BELMONT",
"state": "CA",
"postal_code": "940022935",
"telephone_number": "530-713-0137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3532 ALAMEDA DE LAS PULGAS",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940256510",
"telephone_number": "650-561-9589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EKDAWY",
"first_name": "JUSTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-07",
"last_updated": "2020-10-07",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "299136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.