Individual provider Active NPI

Rucha Kelkar, DPT

  • Physical Therapist
  • San Mateo, CA
National Provider Identifier
1518129394
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 34690 Issued in CA
Practice address
407 N San Mateo Dr
San Mateo, CA 94401-2417
Phone
(949) 293-2950
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT34690 CA
Physical Therapist 225100000X PT 34690 CA Primary

Addresses

Primary practice location

407 N San Mateo Dr
San Mateo, CA 94401-2417

Mailing address

872 Gull Ave
Foster City, CA 94404-1428
Phone (949) 293-2940

Other practice location 1

23961 Calle De La Magdalena Ste 400
Laguna Hills, CA 92653-3683
Phone (949) 587-1155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081110000193 CA Practitioner - Physical Therapist in Private Practice 4082773809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

327 N San Mateo Dr
Suite 5
San Mateo, CA 94401-2585
Phone (650) 431-8946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34640CAMDChiropractor
PT 34690CAMDPhysical Therapist
PT34690CAMDPhysical Therapist
34690CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ayurbliss,LLC CurrentSince Nov 8, 2020 Accepting new patients
Ayurbliss Physical Therapy Inc Physical Therapist CurrentSince Feb 26, 2020 Accepting new patients

Locations

407 N San Mateo Dr
San Mateo, CA 94401
Phone (650) 342-4623

327 N San Mateo Dr
Ste 5
San Mateo, CA 94401
Phone (650) 431-8946

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1518129394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 GULL AVE",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041428",
            "telephone_number": "949-293-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N SAN MATEO DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012417",
            "telephone_number": "949-293-2950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23961 Calle De La Magdalena Ste 400",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926533683",
            "country_code": "US",
            "telephone_number": "949-587-1155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELKAR",
        "first_name": "RUCHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34690",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 34690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.