Active NPI
Samruddha Shenoy, PT, MPT
- Physical Therapist
- Orland Park, IL
National Provider Identifier
1538598222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 07009054
- Practice address
- 15229 Catalina Dr
Unit 3a
Orland Park, IL 60462-4390 - Phone
- (818) 426-7273
- NPI assigned
- Nov 4, 2013
- Last updated
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 07009054 | IL | Primary |
Addresses
Primary practice location
15229 Catalina Dr
Unit 3a
Orland Park, IL 60462-4390
Mailing address
9. Ruby Mansion, 1St Floor,
Gowalia Tank Rd
Mumbai, FOREIGN PROVINCE 400036
IN
Phone 91223859788
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07009054 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1538598222",
"addresses": [
{
"country_code": "IN",
"country_name": "India",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "9. RUBY MANSION, 1ST FLOOR,",
"address_2": "GOWALIA TANK RD",
"city": "MUMBAI",
"state": "FOREIGN PROVINCE",
"postal_code": "400036",
"telephone_number": "91223859788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15229 CATALINA DR",
"address_2": "UNIT 3A",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604624390",
"telephone_number": "818-426-7273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENOY",
"first_name": "SAMRUDDHA",
"credential": "PT, MPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "07009054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.