Individual provider Active NPI

Pratik Kirtikumar Shah, DPT

  • Physical Therapist
  • Fremont, CA
National Provider Identifier
1972510725
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28468 Issued in CA
Practice address
555 Mowry Ave
Suite E
Fremont, CA 94536-4101
Phone
(510) 745-7700
Fax
(510) 279-5657
NPI assigned
Aug 2, 2006
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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 PT28468 CA Primary

Addresses

Primary practice location

555 Mowry Ave
Suite E
Fremont, CA 94536-4101

Mailing address

39120 Argonaut Way
Suite 274
Fremont, CA 94538-1304
Phone (661) 663-8083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000330 CA Practitioner - Physical Therapist in Private Practice 3476616517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imotion Physical Therapy, IncGroup PAC ID 2163585209, 22 clinicians

Practice addresses (Care Compare)

14901 National Ave
Suite 102
Los Gatos, CA 95032-2637
Phone (408) 358-3631

Merit-based Incentive Payment System (MIPS)

Final score
90.96 of 100Reported as group
Quality
85
Improvement activities
40
Cost
73.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28468CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Sports Rehabilitation, Inc. Physical Therapist CurrentSince Dec 1, 2014 Accepting new patients
Imotion Wellness and Fitness Current Accepting new patients

Locations

14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone (408) 358-3631

730 Empey Way
San Jose, CA 95128
Phone (408) 275-1500

Organizations & group practices 3

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1972510725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39120 ARGONAUT WAY",
            "address_2": "SUITE 274",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381304",
            "telephone_number": "661-663-8083",
            "fax_number": "214-580-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MOWRY AVE",
            "address_2": "SUITE E",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364101",
            "telephone_number": "510-745-7700",
            "fax_number": "510-279-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRATIK",
        "middle_name": "KIRTIKUMAR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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, 2008; 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.