Individual provider Active NPI

Annoushka Amanda Ranaraja, PT, DPT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1013518752
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31409 Issued in AZ
Practice address
6824 E Brown Rd Ste 102
Mesa, AZ 85207-3703
Phone
(480) 924-5514
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 31409 AZ Primary

Addresses

Primary practice location

6824 E Brown Rd Ste 102
Mesa, AZ 85207-3703

Mailing address

4455 E Megan St
Gilbert, AZ 85295-5806
Phone (818) 445-1302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230831000563 CO Practitioner - Physical Therapist in Private Practice 1052722568 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab ColoradoGroup PAC ID 1759822265, 12 clinicians

Practice addresses (Care Compare)

2020 N Academy Blvd
Suite 261
Colorado Springs, CO 80909-1567
Phone (908) 670-7573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurologic Rehabilitation CurrentSince Sep 11, 2022 Accepting new patients
Prestige Rehab Colorado Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients
Roaming Rehab LLC Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients
Prestige Rehab LLC Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

3160 N Arizona Ave
Ste 106
Chandler, AZ 85225
Phone (480) 699-4845

3961 E Guadalupe Rd
Ste 1
Gilbert, AZ 85234
Phone (480) 699-4845

2020 N Academy Blvd
Ste 261
Colorado Springs, CO 80909
Phone (719) 232-5591

Organizations & group practices 4

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1013518752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E MEGAN ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852955806",
            "telephone_number": "818-445-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6824 E BROWN RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073703",
            "telephone_number": "480-924-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANARAJA",
        "first_name": "ANNOUSHKA",
        "middle_name": "AMANDA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "31409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.