Individual provider Active NPI

Brindha Agilan, DPT

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1689032955
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039459 Issued in NY
Practice address
10460 Queens Blvd
4Y
Forest Hills, NY 11375-7318
Phone
(909) 800-3930
NPI assigned
Feb 2, 2016
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305210000 VA
Physical Therapist 225100000X 039459 NY Primary

Addresses

Primary practice location

10460 Queens Blvd
4Y
Forest Hills, NY 11375-7318

Mailing address

10460 Queens Blvd
4Y
Forest Hills, NY 11375-7318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200413001312 NY Practitioner - Physical Therapist in Private Practice 8921437013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305210000VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd PT OT & SLP PLLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 5, 2020 Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Mar 9, 2020 Accepting new patients
Parcare Community Health Network Inc CurrentSince Jun 5, 2020 Accepting new patients

Locations

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

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

1 Hanson Pl
Ste 401
Brooklyn, NY 11243
Phone (718) 230-0631

2133 Ralph Ave
Brooklyn, NY 11234
Phone (718) 451-1400

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

4010 Avenue U
Brooklyn, NY 11234
Phone (718) 692-1155

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

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

6010 Bay Pkwy
Ste 902
Brooklyn, NY 11204
Phone (718) 475-1700

31 New Dorp Ln
Staten Island, NY 10306
Phone (718) 370-3500

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, 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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1689032955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10460 QUEENS BLVD",
            "address_2": "4Y",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10460 QUEENS BLVD",
            "address_2": "4Y",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757318",
            "telephone_number": "909-800-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGILAN",
        "first_name": "BRINDHA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210000",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.