Individual provider Active NPI

Prerna Jayesh Gandhi, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1114802014
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053118 Issued in NY
Practice address
455 86TH St,
Brooklyn, NY 11209
Phone
(646) 222-9510
Fax
(212) 404-1826
NPI assigned
Aug 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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 053118 NY Primary

Addresses

Primary practice location

455 86TH St,
Brooklyn, NY 11209

Mailing address

102 Madison Avenue, 8TH FL
New York, NY 10016-6575
Phone (212) 759-2282

Other practice location 1

7518 3rd Ave,
Brooklyn, NY 11209
Phone (646) 347-0080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010002760 NY Practitioner - Physical Therapist in Private Practice 7113424458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spear Physical and Occupational Therapy, LLCGroup PAC ID 6901832112, 582 clinicians

Practice addresses (Care Compare)

455 86TH St
Brooklyn, NY 11209-4707
Phone (646) 222-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spear Physical and Occupational Therapy, LLC Physical Therapist CurrentSince Sep 3, 2025 Accepting new patients
Highline Orthopaedics PastSince Nov 1, 2024 Accepting new patients

Locations

455 86th St
Brooklyn, NY 11209
Phone (646) 222-9510

7518 3rd Ave
Brooklyn, NY 11209
Phone (212) 457-0878

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

102 Madison Ave
Fl 8
New York, NY 10016

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1114802014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MADISON AVENUE, 8TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166575",
            "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": "455 86TH ST,",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "646-222-9510",
            "fax_number": "212-404-1826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7518 3rd Ave,",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11209",
            "country_code": "US",
            "telephone_number": "646-347-0080",
            "fax_number": "212-931-1076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "PRERNA",
        "middle_name": "JAYESH",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.