Individual provider Active NPI

Parthiv Mouleshkumar Pathak, PT

  • Contractor
  • Port Saint Lucie, FL
National Provider Identifier
1043548530
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
PT26280 Issued in FL
Practice address
2328 Bella Vista Way
Port Saint Lucie, FL 34952-2632
Phone
(732) 713-4781
NPI assigned
Nov 23, 2009
Last updated
Sep 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X PT26280 FL Primary
Physical Therapist 225100000X 032052 NY

Addresses

Primary practice location

2328 Bella Vista Way
Port Saint Lucie, FL 34952-2632

Mailing address

2328 Bella Vista Way
Port Saint Lucie, FL 34952-2632
Phone (732) 713-4781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032052NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
G. F.G Medical, P.C PastSince Oct 1, 1997 Accepting new patients
Greater New York Physical Therapy and Chiropractic PLLC Physical Therapist PastSince Mar 1, 2012 Accepting new patients
Doctors United, Inc PastSince Oct 1, 1997 Accepting new patients
N.R. Medical, P.C Past Accepting new patients

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, 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": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1043548530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 BELLA VISTA WAY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522632",
            "telephone_number": "732-713-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 BELLA VISTA WAY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522632",
            "telephone_number": "732-713-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "PARTHIV",
        "middle_name": "MOULESHKUMAR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "PT26280",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.