Individual provider Active NPI

Jenisha Uday Patel, PT

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1639716194
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045248 Issued in NY
Practice address
1415 Richmond Ave
Staten Island, NY 10314-1553
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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 045248 NY Primary

Addresses

Primary practice location

1415 Richmond Ave
Staten Island, NY 10314-1553

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210000211 NY Practitioner - Physical Therapist in Private Practice 0244663037 Reassigns benefits to 4 organizations

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
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians

Practice addresses (Care Compare)

100 N Middletown Rd
Pearl River, NY 10965-2017
Phone (845) 589-0556

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

3820 Bowne St
Flushing, NY 11354-5638
Phone (877) 407-3422

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Mar 14, 2022 Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Oct 13, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
One on One Physical Therapy Services PLLC Physical Therapist PastSince Oct 13, 2021 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

7 Carnegie Plz
Cherry Hill, NJ 08003

111 E 210th St
Bronx, NY 10467

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

100 N Middletown Rd
Pearl River, NY 10965
Phone (845) 589-0556

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

Organizations & group practices 6

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": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1639716194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141553",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JENISHA",
        "middle_name": "UDAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.