Ratna Pratima Vallabhaneni, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA9848 Issued in MA

Practice address

2920 Tibbits Ave
Troy, NY 12180-7077

Phone

(518) 274-4125

NPI assigned

Feb 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1508512906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DUTCH VLG APT 2R",
            "city": "MENANDS",
            "state": "NY",
            "postal_code": "122043017",
            "telephone_number": "610-701-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 TIBBITS AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121807077",
            "telephone_number": "518-274-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLABHANENI",
        "first_name": "RATNA PRATIMA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "010630",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "PTA9848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSISTANT LISCENSE NUMBER",
            "identifier": "010630",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upstate Physician Services, PC
• Rose Urkevich, RD, CDN
• Dino Joel Valentini, DPM
• Maximo B. Valero Jr., MD
• Praveen Choudari Vallabhaneni, DMD
• Jessica Margaret Van Acker, PHARM.D.
• Willis T Van Dyne, PSY D
• Mark Van Leuven, PT
• Charles Van Meter Jr., MD
• Laura Katherine Van Voris, LMSW

• Physical Therapy Assistant in Troy, NY
• Providers in Troy, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.