Individual provider Active NPI

Michi Yamazaki, P.T.

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1891041869
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 39165 Issued in CA
Practice address
2039 Forest Ave
#104
San Jose, CA 95128-4817
Phone
(408) 279-8501
Fax
(408) 279-8504
NPI assigned
Jul 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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 PT 39165 CA Primary

Addresses

Primary practice location

2039 Forest Ave
#104
San Jose, CA 95128-4817

Mailing address

246 Sorbrante Way
Sunnyvale, CA 94086-4807
Phone (408) 733-3670

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121231000240 CA Practitioner - Physical Therapist in Private Practice 4981857828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Rehabilitative Therapy ServicesGroup PAC ID 9739343492, 8 clinicians

Practice addresses (Care Compare)

1716 Miramonte Ave
Mountain View, CA 94040-3763
Phone (650) 934-0455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 39165CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Rehabilitative Therapy Services Physical Therapist CurrentSince Nov 1, 2017 Accepting new patients
Silicon Valley Hand Therapy Physical Therapist CurrentSince Jul 1, 2018 Accepting new patients
Richard P Carr Physical Therapy Inc Physical Therapist Past Accepting new patients
Richard P. Carr Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

1716 Miramonte Ave
Mountain View, CA 94040
Phone (650) 934-0455

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1891041869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 SORBRANTE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864807",
            "telephone_number": "408-733-3670",
            "fax_number": "408-245-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 FOREST AVE",
            "address_2": "#104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284817",
            "telephone_number": "408-279-8501",
            "fax_number": "408-279-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAZAKI",
        "first_name": "MICHI",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-27",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 39165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.