Individual provider Active NPI

Lakshman S Nekkanti, PT

  • Physical Therapist
  • Jamaica, NY
National Provider Identifier
1023785144
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046480 Issued in NY
Practice address
14123 81St Ave
Jamaica, NY 11435-1111
Phone
(940) 390-1882
NPI assigned
Aug 26, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 046480 NY Primary

Addresses

Primary practice location

14123 81St Ave
Jamaica, NY 11435-1111

Mailing address

14123 81St Ave
Jamaica, NY 11435-1111
Phone (940) 390-1882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221116001226 NJ Practitioner - Physical Therapist in Private Practice 9830567262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians
Kayal Medical Group, LLCGroup PAC ID 2961894019, 76 clinicians

Practice addresses (Care Compare)

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

4706 Bergenline Ave
Union City, NJ 07087-5112
Phone (201) 574-7770

9226 John F Kennedy Blvd
Unit B
North Bergen, NJ 07047-5312
Phone (844) 777-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046480NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Multi-Specialty CurrentSince Mar 14, 2023 Accepting new patients
Kayal Medical Group, LLC Multi-Specialty CurrentSince Nov 1, 2022 Accepting new patients
Kayal Orthopaedic Center, P.C. Multi-Specialty PastSince Jun 1, 2020 Accepting new patients

Locations

784 Franklin Ave
Ste 250
Franklin Lks, NJ 07417
Phone (201) 560-0711

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

9226 Kennedy Blvd
Unit B
North Bergen, NJ 07047

185 N Route 17
Ste 101
Paramus, NJ 07652
Phone (201) 560-0711

543 45th St
Union City, NJ 07087
Phone (201) 662-5437

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1023785144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14123 81ST AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351111",
            "telephone_number": "940-390-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14123 81ST AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114351111",
            "telephone_number": "940-390-1882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEKKANTI",
        "first_name": "LAKSHMAN",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.