Individual provider Active NPI

Sreevidya Kowkuntla, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1699344861
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046128 Issued in NY
Practice address
1705 E 17TH St Lowr Level
Brooklyn, NY 11229-2101
Phone
(718) 336-0330
Fax
(718) 336-0073
NPI assigned
Jun 22, 2021
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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 046128 NY Primary

Addresses

Primary practice location

1705 E 17TH St Lowr Level
Brooklyn, NY 11229-2101

Mailing address

1705 E 17TH St Lowr Level
Brooklyn, NY 11229-2101
Phone (718) 336-0330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629001499 NY Practitioner - Physical Therapist in Private Practice 9335540269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

11835 Queens Blvd
Suite 1550
Forest Hills, NY 11375-7215
Phone (718) 544-5730

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 Jun 9, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Jun 9, 2023 Accepting new patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince May 2, 2022 Accepting new patients

Locations

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

111 E 210th St
Bronx, NY 10467

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

8718 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 676-2478

11835 Queens Blvd
Ste 1550
Forest Hills, NY 11375
Phone (718) 544-5730

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

Organizations & group practices 3

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": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1699344861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 E 17TH ST LOWR LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292101",
            "telephone_number": "718-336-0330",
            "fax_number": "718-336-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 17TH ST LOWR LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112292101",
            "telephone_number": "718-336-0330",
            "fax_number": "718-336-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWKUNTLA",
        "first_name": "SREEVIDYA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.