Individual provider Active NPI

Shalmali Sanjay Surlakar

  • Physical Therapist
  • Far Rockaway, NY
National Provider Identifier
1134738149
Registry record updated Jul 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
224 Beach 20TH St
Far Rockaway, NY 11691-3618
Phone
(718) 880-6465
NPI assigned
Jul 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2020

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 Primary

Addresses

Primary practice location

224 Beach 20TH St
Far Rockaway, NY 11691-3618

Mailing address

244 Academy St Unit 2
Jersey City, NJ 07306-3219
Phone (909) 602-7906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424002987 NJ Practitioner - Physical Therapist in Private Practice 8123468162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

403 Valley Brook Ave
Lyndhurst, NJ 07071-1935
Phone (201) 345-5905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince Apr 16, 2024 Accepting new patients

Locations

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

403 Valley Brook Ave
Lyndhurst, NJ 07071
Phone (201) 345-5905

Organizations & group practices 1

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": "1595721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595721600000",
    "number": "1134738149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 ACADEMY ST UNIT 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063219",
            "telephone_number": "909-602-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913618",
            "telephone_number": "718-880-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURLAKAR",
        "first_name": "SHALMALI SANJAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-26",
        "last_updated": "2020-07-26",
        "certification_date": "2020-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.