Individual provider Active NPI

Shruti Janit Mehta

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1194589317
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29394 Issued in FL
Practice address
4411 N Habana Ave
Tampa, FL 33614-7211
Phone
(813) 872-2771
NPI assigned
Feb 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT29394 FL Primary

Addresses

Primary practice location

4411 N Habana Ave
Tampa, FL 33614-7211

Mailing address

13107 Whitestone Dr Apt C
Tampa, FL 33617-9504
Phone (732) 372-5313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903003954 FL Practitioner - Physical Therapist in Private Practice 6608315775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fit 4 Life Personal Training and Physical Therapy IncGroup PAC ID 8022256478, 4 clinicians

Practice addresses (Care Compare)

17419 Bridge Hill Court
Tampa, FL 33647-3599

17419 Bridge Hill CT
Tampa, FL 33647-3599
Phone (813) 907-7879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT29394FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit 4 Life Personal Training & Physical Therapy, Inc. Single Specialty CurrentSince Jul 24, 2024 Accepting new patients

Locations

17419 Bridge Hill Ct
Tampa, FL 33647
Phone (813) 907-7879

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": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1194589317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13107 WHITESTONE DR APT C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336179504",
            "telephone_number": "732-372-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147211",
            "telephone_number": "813-872-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SHRUTI",
        "middle_name": "JANIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT29394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.