Individual provider Active NPI

Deep Shah

  • Physical Therapist
  • New York, NY
National Provider Identifier
1457035065
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050394 Issued in NY
Practice address
88 E 4TH St
New York, NY 10003-9001
Phone
(917) 940-7075
Fax
(917) 688-2321
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 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 050394 NY Primary

Addresses

Primary practice location

88 E 4TH St
New York, NY 10003-9001

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230627001559 NY Practitioner - Physical Therapist in Private Practice 2668830456 Reassigns benefits to 5 organizations
I20250207001398 MI Practitioner - Physical Therapist in Private Practice 2668830456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.23 of 100Reported as individual
Quality
70
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050394NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Feb 13, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jan 1, 2024 Accepting new patients
Behavioral Outcomes Management,LLC Physical Therapist CurrentSince Jan 23, 2025 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jan 1, 2024 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Oct 25, 2024 Accepting new patients
Achieve at Home Physical Therapy PLLC Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Core Physical Therapy Services PC Physical Therapist CurrentSince Oct 8, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients

Locations

210 Town Center Dr
Troy, MI 48084
Phone (248) 643-8900

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

576 Broadhollow Rd
Melville, NY 11747

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

88 E 4th St
New York, NY 10003
Phone (917) 261-5201

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 10

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1457035065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E 4TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039001",
            "telephone_number": "917-940-7075",
            "fax_number": "917-688-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DEEP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050394",
            "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 Jun 14, 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.