Individual provider Active NPI

Amala Sahasrabudhe

  • Physical Therapist
  • New York, NY
National Provider Identifier
1578032322
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297943 Issued in CA
Practice address
675 3Rd Ave
New York, NY 10017-5704
Phone
(909) 645-2053
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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 297943 CA Primary
Physical Therapist 225100000X 042970 NY

Addresses

Primary practice location

675 3Rd Ave
New York, NY 10017-5704

Mailing address

2680 S White Rd
Ste 200
San Jose, CA 95148-2079
Phone (408) 274-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520002093 CA Practitioner - Physical Therapist in Private Practice 4486990439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Hills Orthopedic and Sports Physical Therapy IncGroup PAC ID 1052437209, 13 clinicians

Practice addresses (Care Compare)

2680 S White Rd
Suite 200
San Jose, CA 95148-2079
Phone (408) 274-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
297943CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Hills Orthopedic and Sports Physical Therapy Inc. Physical Therapist CurrentSince May 15, 2021 Accepting new patients
Golden Hills Orthopedic and Sports Physical Therapy Inc. Physical Therapist PastSince May 15, 2021 Accepting new patients

Locations

1436 California Cir
Milpitas, CA 95035
Phone (408) 274-0888

2680 S White Rd
Ste 200
San Jose, CA 95148
Phone (408) 274-0888

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: amala.sahasrabudhe.p2@direct.ucpnyc.nextgenshare.com

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1578032322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD",
            "address_2": "STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482079",
            "telephone_number": "408-274-0888",
            "fax_number": "408-274-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175704",
            "telephone_number": "909-645-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHASRABUDHE",
        "first_name": "AMALA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297943",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.