NPIMap

Organization Active NPI

Washington Outpatient Rehabilitation Center, a Joint Venture

Doing business as Washington Outpatient Rehabilitation Center

  • Physical Therapy Clinic/Center
  • Fremont, CA
National Provider Identifier
1861443434
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
WASHINGTON OUTPATIENT REHABILITATION CENTER, A JOINT VENTURE
Doing business as
Washington Outpatient Rehabilitation Center
Practice address
39141 Civic Center Drive
120
Fremont, CA 94538-5831
Phone
(510) 794-9672
Fax
(510) 792-8138
NPI assigned
May 16, 2006
Last updated
Mar 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Ms. Nancy Farber
Title
President/Ceo
Phone
(510) 745-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

39141 Civic Center Drive
120
Fremont, CA 94538-5831

Mailing address

39141 Civic Center Drive
120
Fremont, CA 94538-5831
Phone (510) 794-9672

Other identifiers 2

IdentifierTypeStateIssuer
GPT001080MedicaidCA
ZZZ34510ZOtherCABLUE SHIELD OF CALIFORNIA

Other names 1

  • Washington Outpatient Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060826000064 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153325576 Receives reassigned benefits from 10 practitioners
Practice locations: Fremont, CA

National Provider Directory

National Provider Directory
Tax ID family
Washington Outpatient R2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3575 Beacon Ave
Fremont, CA 94538
Phone (510) 794-9672

39141 Civic Center Dr
Ste 120
Fremont, CA 94538
Phone (510) 794-9672

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1861443434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DRIVE",
            "address_2": "120",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385831",
            "telephone_number": "510-794-9672",
            "fax_number": "510-792-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DRIVE",
            "address_2": "120",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385831",
            "telephone_number": "510-794-9672",
            "fax_number": "510-792-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON OUTPATIENT REHABILITATION CENTER, A JOINT VENTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "FARBER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "510-745-6500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPT001080",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ34510Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Outpatient Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.