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

OR Nativ, PT, CSCS

Individual provider Physical Therapist · NPI 1588205587

OR Nativ, PT, CSCS is a Physical Therapist in Private Practice in Emeryville, California. Qualified in 2017, 9 years ago. Practices with Stac Physical Therapy Emeryville Inc, an 8-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2019
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2322 Powell St
Emeryville, CA 94608-1738
Phone: (510) 653-5151
Fax: (510) 601-1358
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1588205587
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , CSCS
Sole proprietorYes
NPI enumeratedOctober 1, 2019
Last updated in NPPESNovember 17, 2020
Certification dateNovember 17, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Stac Physical Therapy Emeryville Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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