Individual provider Active NPI

Sidhdhi Shah

  • Physical Therapist
  • Marlborough, MA
National Provider Identifier
1497321061
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
435 Lakeside Ave
Marlborough, MA 01752-1979
Phone
(508) 488-4110
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 MA Primary

Addresses

Primary practice location

435 Lakeside Ave
Marlborough, MA 01752-1979

Mailing address

435 Lakeside Ave
Marlborough, MA 01752-1979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726001111 MA Practitioner - Physical Therapist in Private Practice 7517360761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

104 Main St
Unit 15
Medway, MA 02053-1801
Phone (508) 533-5778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Aug 28, 2023 Accepting new patients
Proex Physical Therapy, LLC CurrentSince Aug 28, 2023 Accepting new patients
Greendale Physical Therapy, LLC Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients

Locations

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

435 Lakeside Ave
Marlborough, MA 01752
Phone (508) 488-4110

104 Main St
Unit 15
Medway, MA 02053
Phone (508) 533-5778

280 Boston Tpke
Shrewsbury, MA 01545
Phone (508) 753-7780

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 3

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1497321061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 LAKESIDE AVE",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LAKESIDE AVE",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521979",
            "telephone_number": "508-488-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SIDHDHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.