Active NPI
Ritu Dudani
- Physical Therapy Clinic/Center
- Sunnyvale, CA
National Provider Identifier
1053040485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 302210
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FX865A | Other | CA | PHYSICAL THERAPY |
| 1679755136 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 302210 | CA | MD | Physical Therapy Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proactive Physical Therapy Inc | Physical Therapy | Current | 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.