Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Fedewa, DPT

Individual provider Physical Therapist · NPI 1316375132

Benjamin Fedewa, DPT is a Physical Therapist in Private Practice in Oakland, California. Qualified in 2013, 13 years ago. Practices with Agile Physical Therapy Inc, a 49-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Washington.

Years since qualifying
13
Licensed in
CA, WA
In the registry since
2013
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792
Phone: (510) 547-1630
Fax: (510) 923-1844
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 399 Grand Ave, Oakland, CA 94610-4825 — (510) 547-1630
  • 4341 Piedmont Ave Ste 103, Oakland, CA 94611-4766 — (510) 547-1630

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT295677 (CA)
Physical Therapist Taxonomy 225100000X · Licence PT60415927 (WA)

Record details

NPI number1316375132
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 15, 2013
Last updated in NPPESMay 27, 2021
Certification dateMay 27, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Agile Physical Therapy Inc — 49 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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