Individual provider Active NPI

Priyank Khushalbhai Patel

  • Physical Therapist
  • New York, NY
National Provider Identifier
1467222802
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
051752 Issued in NY
Practice address
1110 2ND Ave RM 302
New York, NY 10022-2021
Phone
(212) 842-0080
NPI assigned
Jan 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 051752 NY Primary

Addresses

Primary practice location

1110 2ND Ave RM 302
New York, NY 10022-2021

Mailing address

900 Valley Rd Apt E8
Clifton, NJ 07013-4045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240308002846 NY Practitioner - Physical Therapist in Private Practice 5799121000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051752NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Jan 13, 2024 Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1467222802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VALLEY RD APT E8",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070134045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 2ND AVE RM 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222021",
            "telephone_number": "212-842-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYANK",
        "middle_name": "KHUSHALBHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "051752",
            "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 Jan 8, 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.