Individual provider Active NPI

Jaysukh Maganbhai Kalsariya

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1770192262
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044290-1 Issued in NY
Practice address
810 Rogers Ave
Brooklyn, NY 11226-4176
Phone
(718) 940-9010
Fax
(718) 940-9012
NPI assigned
Jul 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 044290-1 NY Primary

Addresses

Primary practice location

810 Rogers Ave
Brooklyn, NY 11226-4176

Mailing address

810 Rogers Ave
Brooklyn, NY 11226-4176

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Brooklyn

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917000904 NY Practitioner - Physical Therapist in Private Practice 6002234416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15144 82ND St
Howard Beach, NY 11414-1777
Phone (347) 435-6360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044290NYMDPharmacist
044290-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission One Physical Therapy PLLC Physical Therapist CurrentSince Mar 24, 2024 Accepting new patients
Active Mobility Physical Therapy of New York PLLC Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Suryanarayan Anand MD PC PastSince Aug 2, 2020 Accepting new patients

Locations

1870 Grand Concourse
Fl 2
Bronx, NY 10457
Phone (347) 431-3824

856 DeKalb Ave
Brooklyn, NY 11221
Phone (718) 222-8777

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1770192262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ROGERS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ROGERS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264176",
            "telephone_number": "718-940-9010",
            "fax_number": "718-940-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALSARIYA",
        "first_name": "JAYSUKH",
        "middle_name": "MAGANBHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044290-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brooklyn",
            "affiliation": "N",
            "address_1": "810 Rogers Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112264176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.