Individual provider Active NPI

Sunanda Prasad

  • Physical Therapist
  • Davis, CA
National Provider Identifier
1235014838
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308590 Issued in CA
Practice address
1460 Drew Ave Ste 200
Davis, CA 95618-4856
Phone
(530) 753-9011
NPI assigned
Aug 11, 2025
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 308590 CA Primary

Addresses

Primary practice location

1460 Drew Ave Ste 200
Davis, CA 95618-4856

Mailing address

1460 Drew Ave Ste 200
Davis, CA 95618-4856
Phone (530) 753-9011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829001650 CA Practitioner - Physical Therapist in Private Practice 4284135344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Edge, Inc.Group PAC ID 7214990399, 9 clinicians

Practice addresses (Care Compare)

1460 Drew Ave
Suite 200
Dans, CA 95618-4856
Phone (530) 753-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308590CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Edge, Inc. Physical Therapist CurrentSince Aug 8, 2025 Accepting new patients
Physical Edge Specialty Services Physical Therapist CurrentSince Aug 8, 2025 Accepting new patients

Locations

1460 Drew Ave
Ste 200
Davis, CA 95618
Phone (530) 753-9011

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1235014838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 DREW AVE STE 200",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956184856",
            "telephone_number": "530-753-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 DREW AVE STE 200",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956184856",
            "telephone_number": "530-753-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "SUNANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.