Individual provider Active NPI

Suresh Kotte, MSPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1417627142
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047301 Issued in NY
Practice address
145 Henry St Apt 1G
Brooklyn, NY 11201-2554
Phone
(718) 521-2424
Fax
(212) 404-8069
NPI assigned
Sep 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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 047301 NY Primary

Addresses

Primary practice location

145 Henry St Apt 1G
Brooklyn, NY 11201-2554

Mailing address

145 Henry St Apt 1G
Brooklyn, NY 11201-2554
Phone (718) 521-2424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260414003136 NY Practitioner - Physical Therapist in Private Practice 9739655192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1305 Paterson Plank Rd
Apt 6403
North Bergen, NJ 07047-1996

3 Grace Ave
Suite 119
Great Neck, NY 11021-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047301NYMDPhysical Therapist

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1417627142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HENRY ST APT 1G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012554",
            "telephone_number": "718-521-2424",
            "fax_number": "212-404-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HENRY ST APT 1G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012554",
            "telephone_number": "718-521-2424",
            "fax_number": "212-404-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTE",
        "first_name": "SURESH",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.