Individual provider Active NPI

Gauravi P. Merchant, P.T.

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1518949023
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26619 Issued in CA
Practice address
12217 Santa Monica Blvd Ste 2
Los Angeles, CA 90025
Phone
(310) 309-3721
Fax
(310) 309-3724
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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 26619 CA Primary

Addresses

Primary practice location

12217 Santa Monica Blvd Ste 2
Los Angeles, CA 90025

Mailing address

12217 Santa Monica Blvd Ste 2
Los Angeles, CA 90025-2589
Phone (310) 309-3721

Other practice location 1

17019 Chatsworth St
Granada Hills, CA 91344-5845
Phone (818) 435-4455

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061122000312 CA Practitioner - Physical Therapist in Private Practice 2163420761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Choice Physical Therapy IncGroup PAC ID 7618985375, 2 clinicians

Practice addresses (Care Compare)

12217 Santa Monica Blvd
Suite 209
West Los Angeles, CA 90025-2589
Phone (818) 359-3253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26619CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1518949023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12217 SANTA MONICA BLVD STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252589",
            "telephone_number": "310-309-3721",
            "fax_number": "310-309-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12217 SANTA MONICA BLVD STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-309-3721",
            "fax_number": "310-309-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17019 Chatsworth St",
            "address_purpose": "LOCATION",
            "city": "Granada Hills",
            "state": "CA",
            "postal_code": "913445845",
            "country_code": "US",
            "telephone_number": "818-435-4455",
            "fax_number": "818-579-9204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "GAURAVI",
        "middle_name": "P.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.