Kim Alexis Mercado Edralin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303917 Issued in CA

Practice address

2680 S White Rd Ste 200
San Jose, CA 95148-2079

Phone

(408) 274-0888

Fax

(408) 274-2858

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Golden Hills Orthopedic and Sports Physical Therapy Inc.

  • Physical Therapist
  • San Jose, CA
  • NPI 1083786230
  Medicare reassignment NPD
• Golden Hills Orthopedic and Sports Physical Therapy Inc.

  • Physical Therapist
  • Milpitas, CA
  • NPI 1750040895
  NPD (past)

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1922790658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482079",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482079",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1436 California Cir",
            "address_purpose": "LOCATION",
            "city": "Milpitas",
            "state": "CA",
            "postal_code": "950353022",
            "country_code": "US",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDRALIN",
        "first_name": "KIM ALEXIS",
        "middle_name": "MERCADO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Edmonds
• Osafanmwen Edogun, RPH
• Edo Edok
• Abel Biruk Edossa
• Jluisa Edquilang
• Eduardo a. Vergara M.D. a Medical Corporation
• Lay Eduarte
• Lynne Bernadette Hebron Eduvala
• Edward E Rotan MD Inc
• Edward H Ryono DDS Incorporated

• Physical Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.