Individual provider Active NPI

Shreshta Tommundrum, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1770302234
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052779 Issued in NY
Practice address
1609 Voorhies Ave
Brooklyn, NY 11235-4092
Phone
(718) 819-3928
NPI assigned
Oct 10, 2024
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 052779 NY Primary

Addresses

Primary practice location

1609 Voorhies Ave
Brooklyn, NY 11235-4092

Mailing address

3465 Chippendale Dr
Sterling Heights, MI 48310-1773
Phone (586) 804-6777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023003791 NY Practitioner - Physical Therapist in Private Practice 7517490915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

1609 Voorhies Ave
Suite 2a
Brooklyn, NY 11235-4095
Phone (718) 819-3926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052779NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1770302234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 CHIPPENDALE DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483101773",
            "telephone_number": "586-804-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 VOORHIES AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354092",
            "telephone_number": "718-819-3928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMMUNDRUM",
        "first_name": "SHRESHTA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Oct 10, 2024; 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.