Active NPI
Payal Gandhi, MPT
- Physical Therapist
- Decatur, IL
National Provider Identifier
1689265589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-026353
- Practice address
- 3004 N Water St Ste C
Decatur, IL 62526-1960 - Phone
- (217) 233-0030
- Fax
- (217) 233-0031
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 046249 | NY | |
| Physical Therapist | 225100000X | 070-026353 | IL | Primary |
Addresses
Primary practice location
3004 N Water St Ste C
Decatur, IL 62526-1960
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046249 | Other | NY | THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046249 | NY | MD | Pharmacist |
| 070-026353 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1689265589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3004 N WATER ST STE C",
"city": "DECATUR",
"state": "IL",
"postal_code": "625261960",
"telephone_number": "217-233-0030",
"fax_number": "217-233-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANDHI",
"first_name": "PAYAL",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "046249",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-026353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT",
"identifier": "046249",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.