Individual provider Active NPI

Nitin Kalra, P.T.

  • Physical Therapist
  • Gainesville, VA
National Provider Identifier
1053559534
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305205268 Issued in VA
Practice address
14366 Broadwinged Dr
Gainesville, VA 20155-5929
Phone
(571) 275-3470
NPI assigned
Jan 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305205268 VA Primary

Addresses

Primary practice location

14366 Broadwinged Dr
Gainesville, VA 20155-5929

Mailing address

41756 Cordgrass Cir
Aldie, VA 20105-5604
Phone (571) 275-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170417000864 VA Practitioner - Physical Therapist in Private Practice 4880979848 Reassigns benefits to 1 organization
I20230920004347 DC Practitioner - Physical Therapist in Private Practice 4880979848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Luna Care Physical Therapy LLCGroup PAC ID 0941615405, 89 clinicians

Practice addresses (Care Compare)

3712 Linda LN
Annandale, VA 22003-1510
Phone (866) 525-3175

5109 Arrowbrook CT
Glen Allen, VA 23060-2876
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305205268VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Sep 7, 2023 Accepting new patients

Locations

8280 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (202) 794-7159

4870 Sadler Rd
Ste 300
Glen Allen, VA 23060
Phone (757) 524-2304

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": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1053559534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41756 CORDGRASS CIR",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055604",
            "telephone_number": "571-275-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14366 BROADWINGED DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201555929",
            "telephone_number": "571-275-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALRA",
        "first_name": "NITIN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.