Individual provider Active NPI

Chitra Kanani, PT

  • Physical Therapist
  • Bayonne, NJ
National Provider Identifier
1063833150
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01534500 Issued in NJ
Practice address
665 Broadway
Bayonne, NJ 07002
Phone
(201) 875-6691
Fax
(201) 455-6691
NPI assigned
Dec 17, 2013
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 40QA01534500 NJ Primary

Addresses

Primary practice location

665 Broadway
Bayonne, NJ 07002

Mailing address

246 Clifton Ave
Clifton, NJ 07011-1900
Phone (201) 875-6691

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
40QA01534500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epoch Physical Therapy Physical Therapist CurrentSince Nov 5, 2020 Accepting new patients
Ignite Physical Therapy & Wellness Center LLC PastSince Jul 6, 2013 Accepting new patients

Locations

2245 US Highway 130
Ste 105
Dayton, NJ 08810
Phone (732) 230-3205

Organizations & group practices 2

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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1063833150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111900",
            "telephone_number": "201-875-6691",
            "fax_number": "201-455-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-875-6691",
            "fax_number": "201-455-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANANI",
        "first_name": "CHITRA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01534500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.