Individual provider Active NPI

Vidhi Jethava

  • Physical Therapist
  • Jackson Heights, NY
National Provider Identifier
1124986690
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
66-P140472-01
Practice address
3457 82ND St Ste 1F
Jackson Heights, NY 11372-2930
Phone
(718) 540-4740
NPI assigned
Jan 13, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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 66-P140472-01 Primary

Addresses

Primary practice location

3457 82ND St Ste 1F
Jackson Heights, NY 11372-2930

Mailing address

3457 82ND St Ste 1F
Jackson Heights, NY 11372-2930

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1124986690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 82ND ST STE 1F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 82ND ST STE 1F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722930",
            "telephone_number": "718-540-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETHAVA",
        "first_name": "VIDHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "66-P140472-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.