Individual provider Active NPI

Padmapriya Kavacheri Subramaniam, DPT

  • Physical Therapist
  • Somerville, MA
National Provider Identifier
1346936598
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27457 Issued in MA
Practice address
5 Middlesex Ave
Somerville, MA 02145-1102
Phone
(617) 591-6840
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 2305216138 VA
Physical Therapist 225100000X 049723 NY
Physical Therapist 225100000X 27457 MA Primary

Addresses

Primary practice location

5 Middlesex Ave
Somerville, MA 02145-1102

Mailing address

3916 Labrador CT Apt 14
Henrico, VA 23233-1276
Phone (804) 709-9990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231128000425 VA Practitioner - Physical Therapist in Private Practice 6507214806 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27457MAMDLicensed Practical Nurse
049723NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Rva Physical Therapy& Sports Rehab, LLC Physical Therapist CurrentSince Oct 17, 2023 Accepting new patients

Locations

5 Middlesex Ave
Somerville, MA 02145
Phone (617) 591-4600

2620 Gaskins Rd
#A
Henrico, VA 23238
Phone (804) 396-6753

107 Heaths Way Rd
Midlothian, VA 23114
Phone (804) 396-6753

Interoperability endpoints

  • Direct secure messaging: pkavacherisubramaniam121512@direct.challiance.masshiway.net

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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1346936598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 LABRADOR CT APT 14",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331276",
            "telephone_number": "804-709-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451102",
            "telephone_number": "617-591-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVACHERI SUBRAMANIAM",
        "first_name": "PADMAPRIYA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216138",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049723",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.