Andi Bala, PT, DPT
Individual provider Active NPI Physical Therapist · Ridgewood, NY
NPI 1104770890 · NPPES record last updated Feb 21, 2026
Key facts
- NPI
- 1104770890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 5505 Myrtle Ave
Ridgewood, NY 11385-3550 - Phone
- (347) 408-2387
- NPI assigned
- Feb 21, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sports Physical Therapy Occupational Therapy and Rehabilitation Servic
Practice addresses (Care Compare)
552 6TH Ave
New York, NY 10011-2010
Phone (212) 741-9288
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260422002298 | NY | Practitioner - Physical Therapist in Private Practice | 8527535004 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spear Physical and Occupational Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
5505 Myrtle Ave
Ridgewood, NY 11385-3550
Mailing address
102 Madison Ave FL 8
New York, NY 10016-7584
Phone (212) 759-2282
NPI Registry JSON
{
"created_epoch": "1771632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771632000000",
"number": "1104770890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 MADISON AVE FL 8",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100167584",
"telephone_number": "212-759-2282",
"fax_number": "212-379-2123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 MYRTLE AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853550",
"telephone_number": "347-408-2387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALA",
"first_name": "ANDI",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-02-21",
"last_updated": "2026-02-21",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
- Ayaan Pharmacy Inc.
- Iris Ayalin
- Lyse Aybar
- B-Home Care LLC
- Babak Behmanesh DDS PC
- Orpiano Baluyut
- Violeta Bangiyev
- Barack Pharmacy & Food Mart Inc
- Amy Barr
- Janice Batista- Fernandez
All providers in Ridgewood, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.