Individual provider Active NPI

Shruti M Shah

  • Physical Therapist
  • East Setauket, NY
National Provider Identifier
1821376211
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032702 Issued in NY
Practice address
8 Technology Dr
104
East Setauket, NY 11733-3327
Phone
(631) 689-8662
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 032702 NY Primary

Addresses

Primary practice location

8 Technology Dr
104
East Setauket, NY 11733-3327

Mailing address

8 Technology Dr
104
East Setauket, NY 11733-3327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515001924 NY Practitioner - Physical Therapist in Private Practice 8224358122 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Li Care Physical Therapy and Occupational Therapy PLLCGroup PAC ID 4587076195, 10 clinicians

Practice addresses (Care Compare)

Smithtown, NY 11787
Phone (516) 946-2503

1842 E Jericho Tpke
Unit P
Huntington, NY 11743-5796
Phone (516) 946-2503

46 Little E Neck Rd
Babylon, NY 11702-2509
Phone (631) 482-1471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Island Musculoskeletal Care MD PC Physical Therapist CurrentSince Oct 1, 2015 Accepting new patients
Island Musculoskeletal Care MD PC Physical Therapist Current Accepting new patients
Island Musculoskeletal Care, MD, PC Physical Therapist CurrentSince Oct 1, 2015 Accepting new patients
L.I. Care Physical Therapy and Occupational Therapy, PLLC Physical Therapist CurrentSince Apr 20, 2022 Accepting new patients
United Rehab Hands on Physical Therapy, PLLC Physical Therapist CurrentSince Oct 9, 2024 Accepting new patients

Locations

1993 Deer Park Ave
Deer Park, NY 11729
Phone (631) 242-4031

700 Horseblock Rd
Farmingville, NY 11738
Phone (631) 676-1739

1842 E Jericho Tpke
Unit P
Huntington, NY 11743
Phone (516) 250-9022

485 New North Ocean Ave
Patchogue, NY 11772
Phone (631) 289-0338

3075 Veterans Memorial Hwy
Ste 101
Ronkonkoma, NY 11779
Phone (631) 389-4640

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 5

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1821376211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TECHNOLOGY DR",
            "address_2": "104",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 TECHNOLOGY DR",
            "address_2": "104",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333327",
            "telephone_number": "631-689-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHRUTI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.