Individual provider Active NPI

Kavya Kshitij Mehta

  • Physical Therapist
  • New York, NY
National Provider Identifier
1265065692
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
043718 Issued in NY
Practice address
30 Wall St Ste 500
New York, NY 10005-2206
Phone
(646) 886-8687
Fax
(212) 656-1091
NPI assigned
Feb 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 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 043718 NY Primary

Addresses

Primary practice location

30 Wall St Ste 500
New York, NY 10005-2206

Mailing address

1 New York PLZ
Concourse Level, Suite L
New York, NY 10004-1901
Phone (646) 886-8687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211001000779 NY Practitioner - Physical Therapist in Private Practice 7214335413 Reassigns benefits to 1 organization
I20220308000350 WA Practitioner - Physical Therapist in Private Practice 7214335413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Rehabilitation PLLCGroup PAC ID 9133012362, 54 clinicians

Practice addresses (Care Compare)

9514 4TH St NE
Unit 101
Lake Stevens, WA 98258-1937
Phone (425) 397-2327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043718NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
Summit Rehabilitation PLLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
New York Plaza Physical Therapy PC Physical Therapist CurrentSince Sep 23, 2021 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
Cascade Rehabilitation Associates, PLLC Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

1 New York Plz
New York, NY 10004
Phone (646) 918-6883

1 New York Plz
Ste L
New York, NY 10004
Phone (212) 256-1171

3710 168th St NE
Ste A102
Arlington, WA 98223
Phone (360) 226-5151

10511 19th Ave SE
Ste B
Everett, WA 98208
Phone (425) 357-8885

9514 4th St NE
Unit 101
Lake Stevens, WA 98258
Phone (425) 397-2327

3719 88th St NE
Ste A
Marysville, WA 98270
Phone (360) 659-9621

17223 Avondale Way NE
Redmond, WA 98052
Phone (425) 403-0232

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1265065692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEW YORK PLZ",
            "address_2": "CONCOURSE LEVEL, SUITE L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041901",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WALL ST STE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052206",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "KAVYA",
        "middle_name": "KSHITIJ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

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