Individual provider Active NPI

Varaha Ravi Dasari, PT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1710499405
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040080 Issued in NY
Practice address
2256 2ND Ave FL 2
New York, NY 10029-2202
Phone
(212) 758-7777
Fax
(212) 758-7777
NPI assigned
Nov 2, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 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 040080 NY Primary

Addresses

Primary practice location

2256 2ND Ave FL 2
New York, NY 10029-2202

Mailing address

651 Academy St
New York, NY 10034-5003
Phone (718) 509-4949

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180116001727 NY Practitioner - Physical Therapist in Private Practice 7315206521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040080NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bukhman MD PC CurrentSince Dec 3, 2017 Accepting new patients
Amb Medical Services, P.C. Past Accepting new patients
Org Medical PLLC PastSince Apr 1, 2008 Accepting new patients

Locations

651 Academy St
New York, NY 10034
Phone (212) 569-2035

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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1710499405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ACADEMY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100345003",
            "telephone_number": "718-509-4949",
            "fax_number": "718-509-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2256 2ND AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100292202",
            "telephone_number": "212-758-7777",
            "fax_number": "212-758-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASARI",
        "first_name": "VARAHA",
        "middle_name": "RAVI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-02",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.