Individual provider Active NPI

Akshaykumar Patel

  • Physical Therapist
  • Passaic, NJ
National Provider Identifier
1114460219
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01826200 Issued in NJ
Practice address
335 Passaic St
Passaic, NJ 07055-5818
Phone
(973) 358-5500
Fax
(973) 358-5501
NPI assigned
Nov 22, 2016
Last updated
Jan 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.022982 IL
Physical Therapist 225100000X J1-0003603 DE
Physical Therapist 225100000X 041468 NY
Physical Therapist 225100000X 40QA01826200 NJ Primary

Addresses

Primary practice location

335 Passaic St
Passaic, NJ 07055-5818

Mailing address

3420 Birch LN
Naperville, IL 60564-1185
Phone (224) 436-5995

Other practice location 1

91 Main St
Paterson, NJ 07505-1026
Phone (973) 358-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606001981 NJ Practitioner - Physical Therapist in Private Practice 7315216348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gands PT LLCGroup PAC ID 5991049983, 2 clinicians

Practice addresses (Care Compare)

335 Passaic St
Passaic, NJ 07055-5818
Phone (973) 358-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0003603DEMDPhysical Therapist
070.022982ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
G&S PT LLC Physical Therapist CurrentSince Feb 5, 2019 Accepting new patients
Janak PT LLC Physical Therapist PastSince Jan 15, 2023 Accepting new patients

Locations

335 Passaic St
Passaic, NJ 07055
Phone (973) 358-5500

91 Main St
Paterson, NJ 07505
Phone (973) 358-5500

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": "1479772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1114460219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 BIRCH LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605641185",
            "telephone_number": "224-436-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PASSAIC ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555818",
            "telephone_number": "973-358-5500",
            "fax_number": "973-358-5501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Main St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075051026",
            "country_code": "US",
            "telephone_number": "973-358-5500",
            "fax_number": "973-358-5501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AKSHAYKUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-22",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.022982",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0003603",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041468",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01826200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.