Individual provider Active NPI

Rochelle Calayag Mitra, DPT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1023721149
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045307 Issued in NY
Practice address
13633 37TH Ave Ste 1C
Flushing, NY 11354-4562
Phone
(718) 961-9800
NPI assigned
Jan 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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 045307 NY Primary

Addresses

Primary practice location

13633 37TH Ave Ste 1C
Flushing, NY 11354-4562

Mailing address

5412 Junction Blvd # 1F
Elmhurst, NY 11373-4620
Phone (631) 469-4959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230120001105 NY Practitioner - Physical Therapist in Private Practice 6204207731 Reassigns benefits to 1 organization
I20240628003165 IL Practitioner - Physical Therapist in Private Practice 6204207731

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Premium Medical Care, PCGroup PAC ID 6507949740, 5 clinicians

Practice addresses (Care Compare)

13633 37TH Ave
Flushing, NY 11354-4561
Phone (718) 961-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045307NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Medical Care, P.C. CurrentSince May 1, 2025 Accepting new patients

Locations

13633 37th Ave
Ste 1C
Flushing, NY 11354
Phone (718) 961-9800

13633 37th Ave
Unit 1BCD
Flushing, NY 11354

13633 37th Ave
#1
Flushing, NY 11354
Phone (718) 961-9800

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1023721149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 JUNCTION BLVD # 1F",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734620",
            "telephone_number": "631-469-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13633 37TH AVE STE 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544562",
            "telephone_number": "718-961-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "ROCHELLE",
        "middle_name": "CALAYAG",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.