Active NPI
Nirajkumar Thakore
- Physical Therapist
- Lake Mary, FL
National Provider Identifier
1245459932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT30291
- Practice address
- 875 Wallace CT Unit 1013
Lake Mary, FL 32746-2161 - Phone
- (734) 578-5171
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT30291 | FL | Primary |
| Physical Therapist | 225100000X | 5501012111 | MI |
Addresses
Primary practice location
875 Wallace CT Unit 1013
Lake Mary, FL 32746-2161
Mailing address
5205 Piper LN
Sanford, FL 32771-5465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
875 Wallace CT
Suite C (Unit 1013)
Lake Mary, FL 32746-3274
Phone (813) 843-2401
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT30291 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regent Therapy Services LLC. | Physical Therapist | Current | Accepting new patients |
Locations
875 Wallace Ct
Unit 1013
Lake Mary, FL 32746
Phone (734) 578-5171
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.
-
- Physical Therapist
- Lake Mary, FL
- NPI 1659950244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1245459932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5205 PIPER LN",
"city": "SANFORD",
"state": "FL",
"postal_code": "327715465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 WALLACE CT UNIT 1013",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462161",
"telephone_number": "734-578-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAKORE",
"first_name": "NIRAJKUMAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT30291",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012111",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.