Individual provider Active NPI

Nilovana Panwalkar

  • Physical Therapist
  • Sunnyvale, CA
National Provider Identifier
1275920167
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42490 Issued in CA
Practice address
263 N Mathilda Ave
Sunnyvale, CA 94086-4830
Phone
(408) 736-7600
Fax
(408) 736-7604
NPI assigned
Apr 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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 036012-1 NY
Physical Therapist 225100000X 42490 CA Primary

Addresses

Primary practice location

263 N Mathilda Ave
Sunnyvale, CA 94086-4830

Mailing address

263 N Mathilda Ave
Sunnyvale, CA 94086-4830
Phone (408) 736-7600

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ29361ZOtherCAGROUP MEDICARE PTAN
1053320325OtherCAGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036012-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1429401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1275920167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 N MATHILDA AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864830",
            "telephone_number": "408-736-7600",
            "fax_number": "408-736-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 N MATHILDA AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940864830",
            "telephone_number": "408-736-7600",
            "fax_number": "408-736-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANWALKAR",
        "first_name": "NILOVANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-19",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036012-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "ZZZ29361Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1053320325",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.