Individual provider Active NPI

Payam Defaii, P.T.

  • Physical Therapist
  • Milpitas, CA
National Provider Identifier
1942373618
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 29767 Issued in CA
Practice address
670 E Calaveras Blvd
Milpitas, CA 95035-5442
Phone
(408) 934-4700
Fax
(408) 934-4701
NPI assigned
Nov 17, 2006
Last updated
Jan 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 29767 CA Primary

Addresses

Primary practice location

670 E Calaveras Blvd
Milpitas, CA 95035-5442

Mailing address

PO Box 612260
San Jose, CA 95161-2260
Phone (877) 325-2776

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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

State licenses

LicenseStateTypeSpecialty
PT 29767CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew 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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1942373618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612260",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951612260",
            "telephone_number": "877-325-2776",
            "fax_number": "408-945-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 E CALAVERAS BLVD",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950355442",
            "telephone_number": "408-934-4700",
            "fax_number": "408-934-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAII",
        "first_name": "PAYAM",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 29767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3555 Whipple Rd",
            "city": "Union City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945871507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milpitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.