Individual provider Active NPI

Shruti Shinde

  • Physical Therapist
  • Lakeway, TX
National Provider Identifier
1619646734
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
300 Medical Pkwy
Lakeway, TX 78738-5627
Phone
(512) 817-0971
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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 Primary

Addresses

Primary practice location

300 Medical Pkwy
Lakeway, TX 78738-5627

Mailing address

1102 Monte Cristo LN
Manchester, CT 06042-7328
Phone (312) 730-8673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018002508 TX Practitioner - Physical Therapist in Private Practice 2961800248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

1221 Graham Dr
Tomball, TX 77375-6407
Phone (346) 222-3060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Sep 4, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Sep 4, 2021 Accepting new patients

Locations

300 Medical Pkwy
Lakeway, TX 78738
Phone (737) 263-0448

265 Plateau Dr
McKinney, TX 75069
Phone (512) 277-6405

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1619646734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 MONTE CRISTO LN",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060427328",
            "telephone_number": "312-730-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PKWY",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787385627",
            "telephone_number": "512-817-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDE",
        "first_name": "SHRUTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.