Shital Gandhi

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26030 Issued in MD

Practice address

45305 Catalina CT Ste 103
Sterling, VA 20166-2337

Phone

(703) 435-7656

Fax

(703) 435-7641

NPI assigned

Jul 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Prime Physical Therapy PLLCGroup PAC ID 2062865389, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Nova Prime Physical Therapy PLLC

  • Physical Therapist
  • Chantilly, VA
  • NPI 1073226825

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1205389475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45305 CATALINA CT STE 103",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662337",
            "telephone_number": "703-435-7656",
            "fax_number": "703-435-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45305 CATALINA CT STE 103",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201662337",
            "telephone_number": "703-435-7656",
            "fax_number": "703-435-7641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19785 Crystal Rock Dr",
            "address_2": "# 309",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "MD",
            "postal_code": "208744700",
            "country_code": "US",
            "telephone_number": "240-724-6781",
            "fax_number": "888-607-7117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "SHITAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2022-11-08",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leasia Freeman
• Edward Frempong, PHARM.D
• Jeanine Marie Fuld, DPT, PT
• Veronica Fulgieri, PT, DPT
• Ricardo Gaitan, D.D.S
• Daintry Kirstin Ganz, MS.ED
• Jacob Ganz
• Emily Elizabeth Gardner
• Ronald Jay Garson, M.D.
• Donald Rene Gauthier, D.C

• Physical Therapist in Sterling, VA
• Providers in Sterling, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.