Individual provider Active NPI

Rupal Ramkumar Yadav

  • Physical Therapist
  • Howard Beach, NY
National Provider Identifier
1316577281
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045436 Issued in NY
Practice address
15144 82ND St
Howard Beach, NY 11414-1777
Phone
(714) 515-0760
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 J1-0004111 DE
Physical Therapist 225100000X 045436 NY Primary

Addresses

Primary practice location

15144 82ND St
Howard Beach, NY 11414-1777

Mailing address

276 Van Wagenen Ave
Jersey City, NJ 07306-5007
Phone (714) 515-0760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311001157 NY Practitioner - Physical Therapist in Private Practice 0547698235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0004111DEMDPhysical Therapist
045436NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bukhman MD PC CurrentSince Jan 3, 2025 Accepting new patients
Org Medical PLLC PastSince Apr 1, 2008 Accepting new patients

Locations

5205 Church Ave
Brooklyn, NY 11203
Phone (718) 342-2500

902 Columbus Ave
New York, NY 10025
Phone (212) 749-5000

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": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1316577281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 VAN WAGENEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065007",
            "telephone_number": "714-515-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15144 82ND ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141777",
            "telephone_number": "714-515-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAV",
        "first_name": "RUPAL",
        "middle_name": "RAMKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0004111",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.