Individual provider Active NPI

Nikhil Porecha, DPT

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1700505039
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02115300 Issued in NJ
Practice address
200 Hudson St Ste 127
Jersey City, NJ 07311-1220
Phone
(201) 721-6130
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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 40QA02115300 NJ Primary

Addresses

Primary practice location

200 Hudson St Ste 127
Jersey City, NJ 07311-1220

Mailing address

200 Hudson St Ste 127
Jersey City, NJ 07311-1220
Phone (201) 721-6130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240105000621 NJ Practitioner - Physical Therapist in Private Practice 1951752724 Reassigns benefits to 1 organization
I20250113000864 NY Practitioner - Physical Therapist in Private Practice 1951752724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Rutgers New Jersey Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolve Physical Therapy, PLLCGroup PAC ID 2668644527, 14 clinicians

Practice addresses (Care Compare)

1317 3Rd Ave
FL 9
New York, NY 10021-2963
Phone (212) 439-1596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evolve Physical Therapy, PLLC Physical Therapist CurrentSince Nov 9, 2024 Accepting new patients
Nunya Health Group LLP Physical Therapist CurrentSince Nov 29, 2023 Accepting new patients

Locations

200 Hudson St
Ste 127
Jersey City, NJ 07311
Phone (201) 721-6130

1317 3rd Ave
Fl 9
New York, NY 10021
Phone (212) 439-1596

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": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1700505039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HUDSON ST STE 127",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073111220",
            "telephone_number": "201-721-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HUDSON ST STE 127",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073111220",
            "telephone_number": "201-721-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORECHA",
        "first_name": "NIKHIL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02115300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.