Individual provider Active NPI

Suhas S Kotian, PT

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1366889719
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01785600 Issued in NJ
Practice address
246 Clifton Ave Ste 5
Clifton, NJ 07011-1900
Phone
(862) 899-7900
Fax
(862) 899-7901
NPI assigned
May 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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 40QA01785600 NJ Primary

Addresses

Primary practice location

246 Clifton Ave Ste 5
Clifton, NJ 07011-1900

Mailing address

246 Clifton Ave Ste 5
Clifton, NJ 07011-1900
Phone (862) 899-7900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628002228 NJ Practitioner - Physical Therapist in Private Practice 1951769645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Comprehensive Physical Therapy LLCGroup PAC ID 9537446570, 13 clinicians

Practice addresses (Care Compare)

246 Clifton Ave
Clifton, NJ 07011-1900
Phone (862) 899-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Comprehensive Physical Therapy LLC Physical Therapist CurrentSince Apr 1, 2023 Accepting new patients
Pro Form Physical Therapy PC Specialist Past Accepting new patients

Locations

246 Clifton Ave
Ste 5
Clifton, NJ 07011
Phone (862) 899-7900

246 Clifton Ave
Clifton, NJ 07011
Phone (862) 899-7900

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1366889719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 CLIFTON AVE STE 5",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111900",
            "telephone_number": "862-899-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 CLIFTON AVE STE 5",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111900",
            "telephone_number": "862-899-7900",
            "fax_number": "862-899-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTIAN",
        "first_name": "SUHAS",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01785600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.