Active NPI
Komal S Shah, R.P.T.
- Physical Therapist
- Sunrise, FL
National Provider Identifier
1871809889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 00004016
- Practice address
- 8304 W Oakland Park Blvd
Sunrise, FL 33351-7308 - Phone
- (954) 540-3858
- Fax
- (954) 748-4910
- NPI assigned
- Aug 27, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 00004016 | FL | Primary |
Addresses
Primary practice location
8304 W Oakland Park Blvd
Sunrise, FL 33351-7308
Mailing address
P.O. Box 10304
Pompano Beach, FL 33061
Phone (954) 540-3858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 00004016 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Rehab Services P a | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Lauderhill, FL
- NPI 1700902160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282867200000",
"number": "1871809889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 10304",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "33061",
"telephone_number": "954-540-3858",
"fax_number": "954-784-4910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8304 W OAKLAND PARK BLVD",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333517308",
"telephone_number": "954-540-3858",
"fax_number": "954-748-4910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KOMAL",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-27",
"last_updated": "2010-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 00004016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.