Individual provider Active NPI

Shivani Kishor Vaidya

  • Physical Therapist
  • New York, NY
National Provider Identifier
1376269332
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
049221 Issued in NY
Practice address
1 New York PLZ Ste L
New York, NY 10004-1901
Phone
(646) 886-8687
Fax
(212) 656-1091
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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 049221 NY Primary

Addresses

Primary practice location

1 New York PLZ Ste L
New York, NY 10004-1901

Mailing address

1 New York PLZ Ste L
New York, NY 10004-1901
Phone (646) 886-8687

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230313002469 NY Practitioner - Physical Therapist in Private Practice 7911371067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Sos PT PCGroup PAC ID 7214955533, 24 clinicians

Practice addresses (Care Compare)

1015 Saw Mill River Rd
Ardsley, NY 10502-1118
Phone (914) 400-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
049221NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Plaza Physical Therapy PC Physical Therapist CurrentSince Oct 16, 2022 Accepting new patients
Health Sos PT PC Physical Therapist CurrentSince Dec 8, 2022 Accepting new patients

Locations

1255 5th Ave
Apt 6L
New York, NY 10029
Phone (914) 390-0080

1 New York Plz
Ste L
New York, NY 10004
Phone (212) 256-1171

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": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1376269332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEW YORK PLZ STE L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041901",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NEW YORK PLZ STE L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041901",
            "telephone_number": "646-886-8687",
            "fax_number": "212-656-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "SHIVANI",
        "middle_name": "KISHOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.