Individual provider Active NPI

Bhoomika Sanjay Timbadiya

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1831854280
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
048036 Issued in NY
Practice address
1785 Forest Ave
Staten Island, NY 10303-2107
Phone
(646) 820-5669
NPI assigned
Nov 1, 2021
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 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 048036 NY Primary

Addresses

Primary practice location

1785 Forest Ave
Staten Island, NY 10303-2107

Mailing address

1785 Forest Ave
Staten Island, NY 10303-2107
Phone (646) 820-5669

Other practice location 1

3377 Richmond Ave
Staten Island, NY 10312-2035
Phone (646) 820-5669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910000079 NY Practitioner - Physical Therapist in Private Practice 7911447644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richmond Physical Therapy, PCGroup PAC ID 3577722727, 15 clinicians

Practice addresses (Care Compare)

1785 Forest Ave
Staten Island, NY 10303-2107
Phone (646) 820-5669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048036NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Richmond Physical Therapy, PC Physical Therapist CurrentSince Aug 30, 2024 Accepting new patients
Freedom Physical Therapy, P.C. PastSince Aug 30, 2024 Accepting new patients

Locations

1785 Forest Ave
Staten Island, NY 10303
Phone (646) 820-5669

3377 Richmond Ave
Staten Island, NY 10312
Phone (646) 820-5669

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, 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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1831854280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032107",
            "telephone_number": "646-820-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032107",
            "telephone_number": "646-820-5669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3377 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103122035",
            "country_code": "US",
            "telephone_number": "646-820-5669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMBADIYA",
        "first_name": "BHOOMIKA",
        "middle_name": "SANJAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.