Individual provider Active NPI

Krutika Panchal

  • Physical Therapist
  • New York, NY
National Provider Identifier
1831721562
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045553 Issued in NY
Practice address
54 Murray St
New York, NY 10007-2219
Phone
(212) 453-4622
Fax
(212) 453-4621
NPI assigned
Feb 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 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 045553 NY Primary

Addresses

Primary practice location

54 Murray St
New York, NY 10007-2219

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716003973 WA Practitioner - Physical Therapist in Private Practice 9739516428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highline Physical Therapy GroupGroup PAC ID 8820172984, 46 clinicians

Practice addresses (Care Compare)

13050 Military Rd S
Highline Therapy Services
Seattle, WA 98168-3047
Phone (206) 248-3080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045553NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Highline Physical Therapy Group Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
Highline Physical Therapy Group Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients

Locations

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

1215 N McDonald Rd
Ste 102
Spokane Valley, WA 99216
Phone (509) 319-2029

13050 Military Rd S
Tukwila, WA 98168
Phone (206) 248-3080

Organizations & group practices 2

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": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1831721562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MURRAY ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100072219",
            "telephone_number": "212-453-4622",
            "fax_number": "212-453-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "KRUTIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.