Active NPI
Surekha S Gajendragadkar, RPT
- Physical Therapist
- Beckley, WV
National Provider Identifier
1609996792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 000398
- Practice address
- 9 Yellow Wood Way
Beckley, WV 25801-7126 - Phone
- (304) 255-2376
- Fax
- (304) 255-7120
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- 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 | 000398 | Primary |
Addresses
Primary practice location
9 Yellow Wood Way
Beckley, WV 25801-7126
Mailing address
9 Yellow Wood Way
Beckley, WV 25801-7126
Phone (304) 255-2376
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7302339000 | Medicaid | WV | |
| 7332914 | Other | WV | AETNA |
| P00687439 | Other | WV | RAILROAD MEDICARE |
| 609079 | Other | WV | CARELINK COVENTRY |
| 7471484 | Other | WV | CIGNA |
| 001975072 | Other | WV | BCBS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590537600000",
"number": "1609996792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 YELLOW WOOD WAY",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258017126",
"telephone_number": "304-255-2376",
"fax_number": "304-255-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 YELLOW WOOD WAY",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258017126",
"telephone_number": "304-255-2376",
"fax_number": "304-255-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAJENDRAGADKAR",
"first_name": "SUREKHA",
"middle_name": "S",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2020-05-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "000398",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7302339000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7332914",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00687439",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARELINK COVENTRY",
"identifier": "609079",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7471484",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "001975072",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.