Active NPI
Anthony Baraan
- Physical Therapist
- San Jose, CA
National Provider Identifier
1962941930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 292856
- Practice address
- 50 Great Oaks Blvd
San Jose, CA 95119-1381 - Phone
- (510) 520-0096
- NPI assigned
- Feb 23, 2017
- Sex
- Male
- 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 | 292856 | CA | Primary |
Addresses
Primary practice location
50 Great Oaks Blvd
San Jose, CA 95119-1381
Mailing address
50 Great Oaks Blvd
San Jose, CA 95119-1381
Phone (510) 520-0096
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 292856 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1962941930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 GREAT OAKS BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191381",
"telephone_number": "510-520-0096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 GREAT OAKS BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951191381",
"telephone_number": "510-520-0096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARAAN",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-23",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "292856",
"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": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "50 Great Oaks Blvd",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "951191381",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.