Radhika Menon, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PTL.0003944 Issued in CO

Practice address

2150 Stadium Dr
Boulder, CO 80309-0001

Phone

(303) 315-9900

Fax

(303) 315-9902

NPI assigned

Mar 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Boulder Community Health

  • Medical Specialty Clinic/Center
  • Boulder, CO
  • NPI 1407685498
  NPD (past)

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1043480668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 MANHATTAN CIR",
            "address_2": "STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034272",
            "telephone_number": "303-543-1201",
            "fax_number": "303-543-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 STADIUM DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803090001",
            "telephone_number": "303-315-9900",
            "fax_number": "303-315-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "RADHIKA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0003944",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CO",
            "license": "PTL.0003944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64624722",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Memoru
• Mend PLLC
• Paula Mendes, M.D.
• Consuelo Elizabeth Mendez-Shannon, PH.D, LMSW
• Mark David Menich, MD
• Mental Health Center Boulder County
• Mental Health Center Boulder County
• Mental Health Center of Boulder
• Mental Health Center of Boulder and Broomfield Counties
• Mental Health Center of Boulder County

• Sports Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Sports Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.