Individual provider Active NPI

Suruch Rashmikant Patel

  • Physical Therapist
  • New York, NY
National Provider Identifier
1124635859
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02330500 Issued in NJ
Practice address
116 E 125TH St
New York, NY 10035-1612
Phone
(212) 426-1284
NPI assigned
Sep 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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 044341 NY
Physical Therapist 225100000X 40QA02330500 NJ Primary

Addresses

Primary practice location

116 E 125TH St
New York, NY 10035-1612

Mailing address

169A Beacon Ave
Jersey City, NJ 07306-2567
Phone (214) 606-4154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210722000251 NY Practitioner - Physical Therapist in Private Practice 1052714516 Reassigns benefits to 3 organizations
I20250605000897 NJ Practitioner - Physical Therapist in Private Practice 1052714516 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02330500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Mar 1, 2023 Accepting new patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince Jul 14, 2021 Accepting new patients
Opportunity Project, Inc. Physical Therapist CurrentSince Aug 7, 2025 Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Aug 7, 2023 Accepting new patients
Prohealth and Fitness PT OT PLLC Physical Therapist CurrentSince Jul 14, 2021 Accepting new patients
Proactive PT LLC Physical Therapist CurrentSince Dec 31, 2023 Accepting new patients

Locations

60 E Willow St
Millburn, NJ 07041
Phone (973) 921-1000

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

150 W End Ave
Apt 1M
New York, NY 10023
Phone (212) 496-2600

Organizations & group practices 6

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": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1124635859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169A BEACON AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062567",
            "telephone_number": "214-606-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 125TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100351612",
            "telephone_number": "212-426-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SURUCH",
        "middle_name": "RASHMIKANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-27",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044341",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02330500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.