Individual provider Active NPI

Nikita Srinivas, P.T.

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1730508359
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011293A Issued in IN
Practice address
1236 Lincoln Ave
Evansville, IN 47714
Phone
(812) 422-8555
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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 05011293A IN Primary

Addresses

Primary practice location

1236 Lincoln Ave
Evansville, IN 47714

Mailing address

1840 National Ave Apt No 215
Indianapolis, IN 46227
Phone (317) 603-1495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241028000245 VA Practitioner - Physical Therapist in Private Practice 8426581646 Reassigns benefits to 1 organization
I20241112004609 DC Practitioner - Physical Therapist in Private Practice 8426581646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

4027 Olley LN
Fairfax, VA 22032-1323
Phone (703) 425-3535

8315 Turning Leaf LN
MC Lean, VA 22102-2615
Phone (571) 662-5825

9619 Burke Lake Rd
Burke, VA 22015-3004
Phone (703) 250-1637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05011293AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Aug 23, 2024 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Aug 23, 2024 Accepting new patients

Locations

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1730508359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 NATIONAL AVE APT NO 215",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46227",
            "telephone_number": "317-603-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-422-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIVAS",
        "first_name": "NIKITA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011293A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.