Individual provider Active NPI

Amruta D Gunjal

  • Physical Therapist
  • Manassas, VA
National Provider Identifier
1306487574
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212776 Issued in VA
Practice address
8575 Rixlew LN
Manassas, VA 20109-3701
Phone
(703) 257-9770
NPI assigned
Sep 30, 2019
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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 2305212776 VA Primary

Addresses

Primary practice location

8575 Rixlew LN
Manassas, VA 20109-3701

Mailing address

13839 Jefferson Park Dr Apt 10401
Herndon, VA 20171-5208
Phone (603) 502-9904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230905001436 DC Practitioner - Physical Therapist in Private Practice 2163885443 Reassigns benefits to 3 organizations
I20231113002768 VA Practitioner - Physical Therapist in Private Practice 2163885443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

12751 Sudley Manor Dr
Bristow, VA 20136-2726
Phone (571) 379-8182

3365 Ogden Rd
Roanoke, VA 24018-1151
Phone 5406827506506

7820 Baltusrol Blvd
Gainesville, VA 20155-3270
Phone (571) 284-7342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305212776VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jul 21, 2023 Accepting new patients
Virginia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Aug 10, 2023 Accepting new patients
Legacy Healthcare Services, Inc Physical Therapist Current Accepting new patients
Rehab Essentials, PLLC Physical Therapist CurrentSince Jul 8, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Jul 21, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jul 22, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

8280 Willow Oaks Corporate Dr
Ste 600
Fairfax, VA 22031
Phone (202) 794-7159

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 6

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1306487574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13839 JEFFERSON PARK DR APT 10401",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201715208",
            "telephone_number": "603-502-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 RIXLEW LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-257-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNJAL",
        "first_name": "AMRUTA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.