Komalben Sureshkumar Patel

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

044368 Issued in NY

Practice address

224 Beach 20TH St
Far Rockaway, NY 11691-3618

Phone

(347) 926-4037

NPI assigned

Oct 4, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1053918953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 E THORNWOOD DR",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601773241",
            "telephone_number": "773-219-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913618",
            "telephone_number": "347-926-4037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "764 E Thornwood Dr",
            "address_purpose": "LOCATION",
            "city": "South Elgin",
            "state": "IL",
            "postal_code": "601773241",
            "country_code": "US",
            "telephone_number": "773-219-9679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMALBEN",
        "middle_name": "SURESHKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parkway Preventive Medical Care PLLC
• Zayne Pascoe Beckford, LMHC
• Anand Patel, PHARMD
• Divyeshkumar Patel, PHYSICAL THERAPIST
• Donali Patel, MD
• Pravinkumar A Patel, RPH
• Roda K Patel, M.D.
• Shashi Patel, MD
• Ila D Patil, PT
• Renisher Bernadine Patterson, MHC

• Physical Therapist in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2020; 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.