Individual provider Active NPI

Rajal Shah, DPT

  • Physical Therapist
  • Roslyn Heights, NY
National Provider Identifier
1508523036
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047619 Issued in NY
Practice address
255 Warner Ave
Roslyn Heights, NY 11577-1000
Phone
(516) 621-5400
NPI assigned
Nov 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 047619 NY Primary

Addresses

Primary practice location

255 Warner Ave
Roslyn Heights, NY 11577-1000

Mailing address

11 Grattan St
New Hyde Park, NY 11040-2409

Other practice location 1

255 Warner Ave
Roslyn Heights, NY 11577-1000
Phone (516) 621-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047619NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1508523036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GRATTAN ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WARNER AVE",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771000",
            "telephone_number": "516-621-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Warner Ave",
            "address_purpose": "LOCATION",
            "city": "Roslyn Heights",
            "state": "NY",
            "postal_code": "115771000",
            "country_code": "US",
            "telephone_number": "516-621-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJAL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.