Organization Active NPI

Rehabcare Drtaneja PLC

  • Physical Medicine & Rehabilitation Physician
  • Broken Arrow, OK
National Provider Identifier
1003415522
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REHABCARE DRTANEJA PLC
Practice address
1200 W Albany St
Broken Arrow, OK 74012-8146
Phone
(918) 744-2338
NPI assigned
Oct 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anand Khurana, MD
Title
Agent
Phone
(918) 779-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1200 W Albany St
Broken Arrow, OK 74012-8146

Mailing address

PO Box 1440
Jenks, OK 74037-1440
Phone (918) 779-9594

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210114000075 OK Part B Supplier - Clinic/Group Practice 6204249170 Receives reassigned benefits from 1 practitioner
Practice locations: Broken Arrow, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1003415522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1440",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740371440",
            "telephone_number": "918-779-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W ALBANY ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128146",
            "telephone_number": "918-744-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABCARE DRTANEJA PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "KHURANA",
        "authorized_official_first_name": "ANAND",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "918-779-5550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.