Active NPI
Orthocare Physical Therapy Center, LLC
- Orthopedic Physical Therapist
- Fairfax, VA
National Provider Identifier
1508393174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 2305205344
- Legal business name
- ORTHOCARE PHYSICAL THERAPY CENTER, LLC
- Practice address
- 13135 Lee Jackson Memorial Hwy Ste 320
Fairfax, VA 22033-1907 - Phone
- (703) 349-5324
- NPI assigned
- May 15, 2017
- Last updated
- May 15, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shruti Ambegaonkar, PT, DPT
- Title
- Owner
- Phone
- (703) 349-5324
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 2305205344 | VA | Primary |
Addresses
Primary practice location
13135 Lee Jackson Memorial Hwy Ste 320
Fairfax, VA 22033-1907
Mailing address
5290 Jule Star Dr
Centreville, VA 20120-3006
Phone (703) 349-5324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
13135 Route 50
Ste 320
Fairfax, VA 22033
Phone (703) 310-7610
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1494806400000",
"number": "1508393174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5290 JULE STAR DR",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201203006",
"telephone_number": "703-349-5324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13135 LEE JACKSON MEMORIAL HWY STE 320",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220331907",
"telephone_number": "703-349-5324"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHOCARE PHYSICAL THERAPY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-15",
"last_updated": "2017-05-15",
"status": "A",
"authorized_official_last_name": "AMBEGAONKAR",
"authorized_official_first_name": "SHRUTI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "703-349-5324",
"authorized_official_credential": "PT, DPT"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "VA",
"license": "2305205344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; 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.