Individual provider Active NPI

Prajakta P Killekar, PT

  • Physical Therapist
  • Woodbridge, VA
National Provider Identifier
1881177095
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212278 Issued in VA
Practice address
13854 Smoketown Rd
Woodbridge, VA 22192-4210
Phone
(703) 670-9935
NPI assigned
Sep 13, 2018
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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 2305212278 VA Primary

Addresses

Primary practice location

13854 Smoketown Rd
Woodbridge, VA 22192-4210

Mailing address

5252 Lyngate CT Ste 203
Burke, VA 22015-1673
Phone (703) 239-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240801004574 DC Practitioner - Physical Therapist in Private Practice 5890232342 Reassigns benefits to 1 organization
I20241105002377 VA Practitioner - Physical Therapist in Private Practice 5890232342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

2620 Main Line Blvd
Alexandria, VA 22301-3081
Phone (571) 531-9038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 22, 2024 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Jun 22, 2024 Accepting new patients
Hand Therapy Experts, LLC Past Accepting new patients
Alliance Rehab and Physical Therapy LLC Physical Therapist Past Accepting new patients
Alliance Rehabilitation, LLC Physical Therapist PastSince Oct 9, 2012 Accepting new patients
Alliance Rehabilitation, LLC Physical Therapist Past Accepting new patients

Locations

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

Organizations & group practices 6

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": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1881177095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 LYNGATE CT STE 203",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151673",
            "telephone_number": "703-239-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13854 SMOKETOWN RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924210",
            "telephone_number": "703-670-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEKAR",
        "first_name": "PRAJAKTA",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.