NPIMap

Individual provider Active NPI

Gauri Shirish Khandekar, MHS, MS, PT

  • Orthopedic Physical Therapist
  • Bellevue, WA
National Provider Identifier
1316984891
Registry record updated May 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT60047288 Issued in WA
Practice address
4122 Factoria Blvd SE Ste 401
Bellevue, WA 98006-5259
Phone
(425) 562-1920
Fax
(425) 562-0054
NPI assigned
Jun 1, 2006
Last updated
May 21, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501012776 MI
Orthopedic Physical Therapist 2251X0800X PT60047288 WA Primary
Orthopedic Physical Therapist 2251X0800X 070015621 IL

Addresses

Primary practice location

4122 Factoria Blvd SE Ste 401
Bellevue, WA 98006-5259

Mailing address

4122 Factoria Blvd SE Ste 401
Bellevue, WA 98006-5259
Phone (425) 562-1920

Other identifiers 3

IdentifierTypeStateIssuer
650F410180OtherMIBCBS OF MI PROVIDER #
650F410180OtherMIBLUE CARE NETWORK
0N72320OtherMIMEDICARE GROUP #

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
070015621ILMDOrthopedic Physical Therapist
PT60047288WAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Physical Therapist PastSince Aug 18, 2025 Accepting new patients
Lakeside Comprehensive Rehabilitation Inc. Physical Therapist PastSince Feb 26, 2011 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 4

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1316984891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 FACTORIA BLVD SE STE 401",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065259",
            "telephone_number": "425-562-1920",
            "fax_number": "425-562-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 FACTORIA BLVD SE STE 401",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065259",
            "telephone_number": "425-562-1920",
            "fax_number": "425-562-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDEKAR",
        "first_name": "GAURI",
        "middle_name": "SHIRISH",
        "credential": "MHS, MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012776",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT60047288",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070015621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI PROVIDER #",
            "identifier": "650F410180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "650F410180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "0N72320",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.