Individual provider Active NPI

Rutvi Mehta, P.T.

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1790933919
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01539200 Issued in NJ
Practice address
9610 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone
(718) 286-3877
Fax
(718) 663-5781
NPI assigned
Aug 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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 40QA01539200 NJ Primary

Addresses

Primary practice location

9610 Metropolitan Ave
Forest Hills, NY 11375-6625

Mailing address

206 Broad St
Red Bank, NJ 07701-2002
Phone (631) 467-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805002041 NJ Practitioner - Physical Therapist in Private Practice 4789845504 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab LLCGroup PAC ID 3375936495, 59 clinicians

Practice addresses (Care Compare)

20 Country Club LN
Colts Neck, NJ 07722-2222
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01539200NJMDPhysical Therapist
030312NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab LLC Physical Therapist CurrentSince Jun 30, 2022 Accepting new patients
Back and Body Medical Center, LLC Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients

Locations

505 E Broad St
Westfield, NJ 07090
Phone (908) 232-5000

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, 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": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1790933919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012002",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 METROPOLITAN AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756625",
            "telephone_number": "718-286-3877",
            "fax_number": "718-663-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "RUTVI",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01539200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.