Individual provider Active NPI

Ritu Dudani

  • Physical Therapy Clinic/Center
  • Sunnyvale, CA
National Provider Identifier
1053040485
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
302210 Issued in CA
Practice address
1208 E Arques Ave Ste 115
Sunnyvale, CA 94085-5419
Phone
(408) 720-1700
Fax
(408) 720-6900
NPI assigned
Jun 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 302210 CA Primary

Addresses

Primary practice location

1208 E Arques Ave Ste 115
Sunnyvale, CA 94085-5419

Mailing address

1208 E Arques Ave Ste 115
Sunnyvale, CA 94085-5419
Phone (408) 720-1700

Other identifiers 2

IdentifierTypeStateIssuer
FX865AOtherCAPHYSICAL THERAPY
1679755136MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL SOAPURL Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
302210CAMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Physical Therapy Inc Physical Therapy CurrentSince Jun 12, 2022 Accepting new patients

Locations

1208 E Arques Ave
Ste 115
Sunnyvale, CA 94085
Phone (408) 505-8266

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": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1053040485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 E ARQUES AVE STE 115",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940855419",
            "telephone_number": "408-720-1700",
            "fax_number": "408-720-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 E ARQUES AVE STE 115",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940855419",
            "telephone_number": "408-720-1700",
            "fax_number": "408-720-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDANI",
        "first_name": "RITU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "302210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "FX865A",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679755136",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SOAPURL",
            "affiliation": "N",
            "endpointDescription": "Laptops",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1208 E Arques Ave Ste 115",
            "city": "Sunnyvale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940855419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.