Individual provider Active NPI

Prachi Nitinbhai Shah, PT

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1871489369
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054307 Issued in NY
Practice address
5205 Van Loon St
Elmhurst, NY 11373-4258
Phone
(347) 220-8195
Fax
(866) 202-3177
NPI assigned
Jun 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 054307 NY Primary

Addresses

Primary practice location

5205 Van Loon St
Elmhurst, NY 11373-4258

Mailing address

5205 Van Loon St
Elmhurst, NY 11373-4258
Phone (347) 220-8195

Other practice location 1

13630 Maple Ave Ste 2K
Flushing, NY 11355-3868
Phone (347) 437-0325

Other practice location 2

13630 Maple Ave Ste 2I
Flushing, NY 11355-3868
Phone (347) 437-0325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250619000038 NY Practitioner - Physical Therapist in Private Practice 7810408515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
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)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054307NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
L.I. Care Physical Therapy and Occupational Therapy, PLLC Single Specialty CurrentSince Jan 5, 2026 Accepting new patients
Energize Physical Therapy PLLC Physical Therapist CurrentSince Jun 13, 2025 Accepting new patients

Locations

5205 Van Loon St
Elmhurst, NY 11373
Phone (347) 220-8195

13630 Maple Ave
Ste 2I
Flushing, NY 11355
Phone (347) 220-8195

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

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": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1871489369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 VAN LOON ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734258",
            "telephone_number": "347-220-8195",
            "fax_number": "866-202-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 VAN LOON ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734258",
            "telephone_number": "347-220-8195",
            "fax_number": "866-202-3177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13630 Maple Ave Ste 2K",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553868",
            "country_code": "US",
            "telephone_number": "347-437-0325",
            "fax_number": "866-202-3177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13630 Maple Ave Ste 2I",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553868",
            "country_code": "US",
            "telephone_number": "347-437-0325",
            "fax_number": "866-202-3177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRACHI",
        "middle_name": "NITINBHAI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; 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.