Individual provider Active NPI

Khyati Tejas Patel

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1467236000
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029790 Issued in NY
Practice address
110 Henderson Ave
Staten Island, NY 10301-2108
Phone
(718) 727-8100
NPI assigned
Aug 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 029790 NY Primary

Addresses

Primary practice location

110 Henderson Ave
Staten Island, NY 10301-2108

Mailing address

1656 Ohio Ave
North Brunswick, NJ 08902-1481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002002358 NY Practitioner - Physical Therapist in Private Practice 9830543362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Rehabilitation PT PCGroup PAC ID 3678045044, 10 clinicians
Ats Rehab OT and PT and SLP PLLCGroup PAC ID 2567734452, 39 clinicians

Practice addresses (Care Compare)

110 Henderson Ave
Staten Island, NY 10301-2108
Phone (732) 399-9700

274 W Broadway
Long Beach, NY 11561-3911
Phone (718) 809-4370

636 Louisiana Ave
Brooklyn, NY 11239-1526
Phone (732) 399-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ats Rehab OT & PT & SLP PLLC Single Specialty CurrentSince Jul 30, 2023 Accepting new patients

Locations

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

110 Henderson Ave
Staten Island, NY 10301
Phone (516) 295-1924

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1467236000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 OHIO AVE",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HENDERSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012108",
            "telephone_number": "718-727-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KHYATI",
        "middle_name": "TEJAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.