Individual provider Active NPI

Mandakini Dhirubhai Desai, RPT

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1003194077
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032867 Issued in NY
Practice address
292 Saint Pauls Ave FL 2
Jersey City, NJ 07306-5009
Phone
(217) 619-3025
Fax
(718) 463-8880
NPI assigned
Jul 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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 032867 NY Primary

Addresses

Primary practice location

292 Saint Pauls Ave FL 2
Jersey City, NJ 07306-5009

Mailing address

292 Saint Pauls Ave FL 2
Jersey City, NJ 07306-5009
Phone (217) 619-3025

Other identifiers 1

IdentifierTypeStateIssuer
032867OtherNYLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210713000917 NJ Practitioner - Physical Therapist in Private Practice 8921277914 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Temple University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holsman Physical and Occupational Therapy PCGroup PAC ID 8426294455, 17 clinicians
Holsman Physical Therapy and Wellness PCGroup PAC ID 2062666910, 24 clinicians

Practice addresses (Care Compare)

15 -01 Broadway
Suite 12
Fair Lawn, NJ 07410-6018
Phone (201) 355-5199

408 Pompton Ave
Cedar Grove, NJ 07009-1813
Phone (973) 433-0732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Home Therapy, LLC CurrentSince Jul 6, 2021 Accepting new patients
Holsman Physical Therapy and Wellness PC CurrentSince Jul 6, 2021 Accepting new patients
Holsman Physical Therapy and Rehabilitation PC Physical Therapist CurrentSince Jul 6, 2021 Accepting new patients
Holsman Physical and Occupational Therapy PC Physical Therapist CurrentSince Jul 6, 2021 Accepting new patients
Holsman Physical and Occupational Therapy, PC CurrentSince Jul 6, 2021 Accepting new patients

Locations

408 Pompton Ave
Cedar Grove, NJ 07009
Phone (973) 433-0732

1700 State Rt 3
Clifton, NJ 07013
Phone (862) 249-4901

1070 Clifton Ave
Ste 1A
Clifton, NJ 07013
Phone (973) 246-6565

15-01 Broadway
Ste 12
Fair Lawn, NJ 07410
Phone (201) 355-5199

711 Kearny Ave
#2
Kearny, NJ 07032
Phone (201) 535-8555

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1003194077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 SAINT PAULS AVE FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065009",
            "telephone_number": "217-619-3025",
            "fax_number": "718-463-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 SAINT PAULS AVE FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065009",
            "telephone_number": "217-619-3025",
            "fax_number": "718-463-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "MANDAKINI",
        "middle_name": "DHIRUBHAI",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "032867",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.