Individual provider Active NPI

Manijot Kaur Grewal, PT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1700446861
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34590 Issued in FL
Practice address
3802 Ehrlich Rd Ste 309
Tampa, FL 33624-2355
Phone
(813) 725-4265
Fax
(813) 725-4451
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 34590 FL Primary

Addresses

Primary practice location

3802 Ehrlich Rd Ste 309
Tampa, FL 33624-2355

Mailing address

3802 Ehrlich Rd Ste 309
Tampa, FL 33624-2355
Phone (813) 725-4265

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230502003200 FL Practitioner - Physical Therapist in Private Practice 3971968660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3802 Ehrlich Rd
Suite 309
Tampa, FL 33624-2355
Phone (813) 725-4265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34590FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carewell Physical Therapy & Balance Center LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Nalin LLC Physical Therapist CurrentSince Apr 13, 2023 Accepting new patients
Venice Rehab, LLC Physical Therapist PastSince Apr 13, 2023 Accepting new patients

Locations

5860 Ranch Lake Blvd
Ste 102
Bradenton, FL 34202
Phone (941) 212-1444

3802 Ehrlich Rd
Ste 309
Tampa, FL 33624
Phone (813) 468-8171

7417 Monika Manor Dr
Tampa, FL 33625
Phone (813) 438-3579

Networks

  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1700446861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 EHRLICH RD STE 309",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242355",
            "telephone_number": "813-725-4265",
            "fax_number": "813-725-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 EHRLICH RD STE 309",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242355",
            "telephone_number": "813-725-4265",
            "fax_number": "813-725-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "MANIJOT",
        "middle_name": "KAUR",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "34590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.