Individual provider Active NPI

Kanchan Rana

  • Physical Therapist
  • Naperville, IL
National Provider Identifier
1699212423
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014889 Issued in MI
Practice address
1312 Strawbridge CT
Naperville, IL 60565-1705
Phone
(954) 383-8208
NPI assigned
Jan 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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 5501014889 MI Primary

Addresses

Primary practice location

1312 Strawbridge CT
Naperville, IL 60565-1705

Mailing address

1312 Strawbridge CT
Naperville, IL 60565-1705
Phone (954) 383-8208

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

LicenseStateTypeSpecialty
5501014889MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revival Physical Therapy & Rehabilitation Services, PC CurrentSince Sep 11, 2020 Accepting new patients
Brian Mayrsohn MD PLLC PastSince Jan 1, 2023 Accepting new patients

Locations

3319 3rd Ave
Bronx, NY 10456
Phone (347) 591-4136

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": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1699212423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 STRAWBRIDGE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651705",
            "telephone_number": "954-383-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 STRAWBRIDGE CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651705",
            "telephone_number": "954-383-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANA",
        "first_name": "KANCHAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.