Individual provider Active NPI

Kanikkai Steni Balan Sackiriyas, DSC

  • Physical Therapist
  • Sunrise, FL
National Provider Identifier
1346672003
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
034920 Issued in NY
Practice address
1580 Sawgrass Corporate Pkwy
Suite 100
Sunrise, FL 33323-2859
Phone
(800) 886-8108
Fax
(866) 422-6431
NPI assigned
Aug 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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 034920 NY Primary
Physical Therapist 225100000X 2305207892 VA

Addresses

Primary practice location

1580 Sawgrass Corporate Pkwy
Suite 100
Sunrise, FL 33323-2859

Mailing address

4011 N Pine Island Rd
Shamrock Apartments, Apt 304
Sunrise, FL 33351-6520
Phone (909) 991-5445

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
034920NYMDPharmacist
2305207892VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medpro Healthcare Staffing Past Accepting new patients

Organizations & group practices 1

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1346672003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 N PINE ISLAND RD",
            "address_2": "SHAMROCK APARTMENTS, APT 304",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516520",
            "telephone_number": "909-991-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "address_2": "SUITE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232859",
            "telephone_number": "800-886-8108",
            "fax_number": "866-422-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKIRIYAS",
        "first_name": "KANIKKAI STENI BALAN",
        "credential": "DSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034920",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.