Individual provider Active NPI

Murtaza Khumri

  • Contractor
  • Indianapolis, IN
National Provider Identifier
1235344169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
05009217A Issued in IN
Practice address
5980 W 71St St
Suite 201
Indianapolis, IN 46278-2711
Phone
(317) 388-0800
Fax
(317) 388-0805
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 05009217A IN Primary

Addresses

Primary practice location

5980 W 71St St
Suite 201
Indianapolis, IN 46278-2711

Mailing address

5980 W 71St St
Suite 201
Indianapolis, IN 46278-2711
Phone (317) 388-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110124000129 NY Practitioner - Physical Therapist in Private Practice 8820277817 Reassigns benefits to 1 organization
I20190809000190 CT Practitioner - Physical Therapist in Private Practice 8820277817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT CT, LLCGroup PAC ID 8820235575, 76 clinicians

Practice addresses (Care Compare)

Southbury, CT 06488
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11238CTMDSocial Worker
05009217AINMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT CT, LLC CurrentSince Mar 1, 2023 Accepting new patients
Optimum Therapeutics PT & OT PLLC CurrentSince Apr 27, 2021 Accepting new patients
Rehabpro Physical Therapy, PC PastSince Jun 12, 2019 Accepting new patients
Propel Physical Therapy PC PastSince Apr 27, 2021 Accepting new patients
Access Therapies at Home Past Accepting new patients

Locations

1 Huntington Quadrangle
Ste 1S07
Melville, NY 11747
Phone (516) 222-2010

560 Broadhollow Rd
Ste 304
Melville, NY 11747
Phone (516) 222-2010

Organizations & group practices 5

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235344169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5980 W 71ST ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782711",
            "telephone_number": "317-388-0800",
            "fax_number": "317-388-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 W 71ST ST",
            "address_2": "SUITE 201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782711",
            "telephone_number": "317-388-0800",
            "fax_number": "317-388-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUMRI",
        "first_name": "MURTAZA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "IN",
            "license": "05009217A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.