Individual provider Active NPI

Ketki Pathak, PT

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1578710042
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01043400 Issued in NJ
Practice address
42 Parsonage Rd
Edison, NJ 08837-2782
Phone
(732) 902-2700
Fax
(949) 862-7791
NPI assigned
Aug 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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 40QA01043400 NJ Primary

Addresses

Primary practice location

42 Parsonage Rd
Edison, NJ 08837-2782

Mailing address

42 Parsonage Rd
Edison, NJ 08837-2782
Phone (732) 902-2700

Other identifiers 2

IdentifierTypeStateIssuer
072616DBDOtherMEDICARE
072616YEW7OtherNJMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090202000562 NJ Practitioner - Physical Therapist in Private Practice 1456415686 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Feb 1, 2019 Accepting new patients
PN Consultancy Services Inc. Physical Therapist CurrentSince Mar 17, 2015 Accepting new patients
PN Consultancy Services Inc. Physical Therapist CurrentSince Mar 17, 2015 Accepting new patients
Asap Physical Therapy PastSince Jan 18, 2011 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

7 Carnegie Plz
Cherry Hill, NJ 08003

42 Parsonage Rd
Edison, NJ 08837
Phone (732) 548-5151

161 Route 27
Edison, NJ 08820
Phone (732) 902-2700

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

Organizations & group practices 4

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": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1578710042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 PARSONAGE RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372782",
            "telephone_number": "732-902-2700",
            "fax_number": "949-862-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 PARSONAGE RD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088372782",
            "telephone_number": "732-902-2700",
            "fax_number": "949-862-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "KETKI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01043400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "072616DBD",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "072616YEW7",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.