Individual provider Active NPI

Viveki Pandya, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1215507579
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047277 Issued in NY
Practice address
684 W Fingerboard Rd
Staten Island, NY 10305-2630
Phone
(718) 442-1003
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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 047277 NY Primary

Addresses

Primary practice location

684 W Fingerboard Rd
Staten Island, NY 10305-2630

Mailing address

1132 Morning Glory Dr
Monroe TWP, NJ 08831-5350
Phone (609) 937-4851

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210826003000 NY Practitioner - Physical Therapist in Private Practice 9739584863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grasmere Physical Therapy Wellness PLLCGroup PAC ID 1052834140, 3 clinicians
Grasmere Physical Therapy and Rehabilitation PLLCGroup PAC ID 9234429424, 3 clinicians

Practice addresses (Care Compare)

1130 Victory Blvd
Staten Island, NY 10301-3623
Phone (718) 442-1003

684 W Fingerboard Rd
Staten Island, NY 10305-2630
Phone (718) 442-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grasmere Physical Therapy and Rehabilitation, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Grasmere Physical Therapy Wellness, PLLC Physical Therapist CurrentSince Dec 31, 2025 Accepting new patients

Locations

1130 Victory Blvd
Staten Island, NY 10301
Phone (718) 442-1003

Organizations & group practices 2

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1215507579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 MORNING GLORY DR",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088315350",
            "telephone_number": "609-937-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 W FINGERBOARD RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052630",
            "telephone_number": "718-442-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "VIVEKI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; 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.