Individual provider Active NPI

Nagaraja Tiruvalam, PT

  • Physical Therapist
  • Delray Beach, FL
National Provider Identifier
1619964921
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10382 Issued in FL
Practice address
6200 W Atlantic Ave
#201
Delray Beach, FL 33484-3506
Phone
(561) 499-3041
Fax
(561) 499-3042
NPI assigned
Oct 3, 2005
Last updated
Nov 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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 PT10382 FL Primary

Addresses

Primary practice location

6200 W Atlantic Ave
#201
Delray Beach, FL 33484-3506

Mailing address

6200 W Atlantic Ave Ste 201
Delray Beach, FL 33484-3506
Phone (561) 499-3041

Other identifiers 2

IdentifierTypeStateIssuer
Y7949OtherFLBLUE CROSS BLUE SHIELD
6697453OtherFLGHI

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1619964921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 W ATLANTIC AVE STE 201",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334843506",
            "telephone_number": "561-499-3041",
            "fax_number": "561-499-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 W ATLANTIC AVE",
            "address_2": "#201",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334843506",
            "telephone_number": "561-499-3041",
            "fax_number": "561-499-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIRUVALAM",
        "first_name": "NAGARAJA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y7949",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6697453",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.