Individual provider Active NPI

Tejal Kishore Sanover

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1093028862
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27425 Issued in MD
Practice address
200 E 16TH St
Frederick, MD 21701-4400
Phone
(301) 662-8700
NPI assigned
Jul 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 032386-1 NY
Physical Therapist 225100000X 27425 MD Primary

Addresses

Primary practice location

200 E 16TH St
Frederick, MD 21701-4400

Mailing address

22944 Newcut Rd # 2302
Clarksburg, MD 20871-9307
Phone (917) 287-8728

Other practice location 1

200 W 57th St
Suite 900
New York, NY 10019-3211
Phone (212) 981-1977

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
PT 032386-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1093028862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22944 NEWCUT RD # 2302",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208719307",
            "telephone_number": "917-287-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 16TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014400",
            "telephone_number": "301-662-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W 57th St",
            "address_2": "Suite 900",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100193211",
            "country_code": "US",
            "telephone_number": "212-981-1977",
            "fax_number": "212-643-9192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANOVER",
        "first_name": "TEJAL",
        "middle_name": "KISHORE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-21",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "PT 032386-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.