Individual provider Active NPI

Ketki S Vyas, DPT

  • Physical Therapist
  • North Brunswick, NJ
National Provider Identifier
1740587187
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00933100 Issued in NJ
Practice address
620 Towne Centre Dr
North Brunswick, NJ 08902-1236
Phone
(732) 658-1896
Fax
(732) 790-0952
NPI assigned
Feb 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 40QA00933100 NJ
Orthopedic Physical Therapist 2251X0800X 40QA00933100 NJ
Physical Therapist 225100000X 40QA00933100 NJ Primary

Addresses

Primary practice location

620 Towne Centre Dr
North Brunswick, NJ 08902-1236

Mailing address

19 Parkside Dr
North Brunswick, NJ 08902
Phone (732) 658-1896

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110523000758 NJ Practitioner - Physical Therapist in Private Practice 1557547783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of New England, College of Osteo Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

620 Towne Centre Dr
North Brunswick, NJ 08902-1236
Phone (732) 658-1896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00933100NJMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizons Physical Therapy & Lymphedema Care LLC Physical Therapist CurrentSince Feb 12, 2011 Accepting new patients

Locations

620 Towne Centre Dr
North Brunswick, NJ 08902
Phone (732) 658-1896

Organizations & group practices 1

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1740587187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 PARKSIDE DR",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "08902",
            "telephone_number": "732-658-1896",
            "fax_number": "732-790-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 TOWNE CENTRE DR",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021236",
            "telephone_number": "732-658-1896",
            "fax_number": "732-790-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VYAS",
        "first_name": "KETKI",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NJ",
            "license": "40QA00933100",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00933100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00933100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.