Individual provider Active NPI

Rutvee Jatin Mehta

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1194363788
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045301 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
Fax
(516) 466-7723
NPI assigned
Dec 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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
Physical Therapist 225100000X 045301 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

20 Emma St
Bethpage, NY 11714-4430
Phone (516) 728-4531

Other practice location 1

20 Emma St
Bethpage, NY 11714-4430
Phone (516) 728-4531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200722003144 NY Practitioner - Physical Therapist in Private Practice 1759705882 Reassigns benefits to 2 organizations
I20250317002310 CA Practitioner - Physical Therapist in Private Practice 1759705882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Creek Fitness and Physical TherapyGroup PAC ID 7012994791, 38 clinicians

Practice addresses (Care Compare)

1395 1St St
Suite 100
Gilroy, CA 95020-3876
Phone (408) 846-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045301NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Creek Fitness and Physical Therapy Physical Therapist CurrentSince Mar 24, 2025 Accepting new patients
Silver Creek Physical Therapy Gilroy Physical Therapist CurrentSince Mar 24, 2025 Accepting new patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Jul 1, 2020 Accepting new patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Apr 1, 2022 Accepting new patients

Locations

1395 1st St
Ste 100
Gilroy, CA 95020
Phone (408) 703-8582

14107 Winchester Blvd
Ste O
Los Gatos, CA 95032
Phone (408) 724-8264

5600 Mowry School Rd
Ste 305
Newark, CA 94560
Phone (510) 651-9258

121 Bernal Rd
San Jose, CA 95119
Phone (408) 227-2141

4205 San Felipe Rd
Ste 100
San Jose, CA 95135
Phone (408) 238-1552

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

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

Organizations & group practices 4

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": "1576281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1194363788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EMMA ST",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117144430",
            "telephone_number": "516-728-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Emma St",
            "address_purpose": "LOCATION",
            "city": "Bethpage",
            "state": "NY",
            "postal_code": "117144430",
            "country_code": "US",
            "telephone_number": "516-728-4531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RUTVEE",
        "middle_name": "JATIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-14",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

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