Individual provider Active NPI

Kirti Shetty, M.P.T

  • Physical Therapist
  • North Bergen, NJ
National Provider Identifier
1255671285
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01482500 Issued in NJ
Practice address
3161 Kennedy Blvd
North Bergen, NJ 07047-2303
Phone
(201) 937-2758
NPI assigned
Feb 28, 2013
Last updated
Feb 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01482500 NJ Primary
Physical Therapist 225100000X 033792 NY

Addresses

Primary practice location

3161 Kennedy Blvd
North Bergen, NJ 07047-2303

Mailing address

45 Cottage St
Apt # 4
Jersey City, NJ 07306-2800
Phone (201) 912-6420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130823000688 NJ Practitioner - Physical Therapist in Private Practice 5294973079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Comprehensive Physical Therapy LLCGroup PAC ID 9537446570, 13 clinicians

Practice addresses (Care Compare)

246 Clifton Ave
Clifton, NJ 07011-1900
Phone (862) 899-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
40QA01482500NJMDPhysical Therapist
033792NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Comprehensive Physical Therapy LLC Physical Therapist CurrentSince Apr 16, 2024 Accepting new patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Jun 26, 2017 Accepting new patients
Recover Pro Medical & Wellness Physical Therapist Past Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist PastSince Oct 16, 2009 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

246 Clifton Ave
Clifton, NJ 07011
Phone (862) 899-7900

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

Organizations & group practices 4

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": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1255671285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 COTTAGE ST",
            "address_2": "APT # 4",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062800",
            "telephone_number": "201-912-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070472303",
            "telephone_number": "201-937-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "KIRTI",
        "credential": "M.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01482500",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.