Active NPI
Palak Dweepkumar Shah
- Physical Therapist
- Lakewood, WA
National Provider Identifier
1528595212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 32422
- Practice address
- 10401 116TH St CT SW
Apt K
Lakewood, WA 98498 - Phone
- (862) 686-9125
- NPI assigned
- May 12, 2017
- Last updated
- May 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 32422 | FL | Primary |
| Physical Therapist | 225100000X | J1-0003464 | DE |
Addresses
Primary practice location
10401 116TH St CT SW
Apt K
Lakewood, WA 98498
Mailing address
10401 116TH Street CT SW
Apt K
Lakewood, WA 98498-1362
Phone (862) 686-9125
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
| License | State | Type | Specialty |
|---|---|---|---|
| J1-0003464 | DE | MD | Physical Therapist |
| PT 32422 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burke Collins Therapy, Inc | Past | Accepting new patients |
Networks
- Optimum HealthCare HMO Network
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Back To Work Physical Therapy
- Orthopedic Physical Therapist
- Brandon, FL
- NPI 1730295734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494547200000",
"number": "1528595212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10401 116TH STREET CT SW",
"address_2": "APT K",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984981362",
"telephone_number": "862-686-9125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10401 116TH ST CT SW",
"address_2": "APT K",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "98498",
"telephone_number": "862-686-9125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "PALAK",
"middle_name": "DWEEPKUMAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-12",
"last_updated": "2017-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 32422",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DE",
"license": "J1-0003464",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.