Individual provider Active NPI

Meher P Daruwalla

  • Physical Therapist
  • South Richmond Hill, NY
National Provider Identifier
1265158299
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049522 Issued in NY
Practice address
11515 101St Ave
South Richmond Hill, NY 11419-1247
Phone
(718) 441-5333
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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 049522 NY Primary

Addresses

Primary practice location

11515 101St Ave
South Richmond Hill, NY 11419-1247

Mailing address

87 Half Laidlaw Ave
Apt 2
Jersey City, NJ 07306-2145
Phone (201) 706-1206

Other practice location 1

87 Half Laidlaw Ave
Apt 2
Jersey City, NJ 07306-2145
Phone (201) 706-1206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220000315 NY Practitioner - Physical Therapist in Private Practice 4789053422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049522NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Nov 15, 2024 Accepting new patients
Heartshare PastSince Oct 16, 2022 Accepting new patients

Locations

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1265158299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 HALF LAIDLAW AVE",
            "address_2": "APT 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062145",
            "telephone_number": "201-706-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 101ST AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191247",
            "telephone_number": "718-441-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 Half Laidlaw Ave",
            "address_2": "Apt 2",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073062145",
            "country_code": "US",
            "telephone_number": "201-706-1206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARUWALLA",
        "first_name": "MEHER",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Richmond Hill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.