Individual provider Active NPI

Sheila Janda, P.T.

  • Physical Therapist
  • Middletown, NY
National Provider Identifier
1902818354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015643-1 Issued in NY
Practice address
390 Crystal Run Rd
Suite 104
Middletown, NY 10941-7000
Phone
(845) 703-3070
Fax
(745) 703-3072
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 015643-1 NY Primary

Addresses

Primary practice location

390 Crystal Run Rd
Suite 104
Middletown, NY 10941-7000

Mailing address

390 Crystal Run Rd
Suite 104
Middletown, NY 10941-7000
Phone (845) 703-3070

Other identifiers 4

IdentifierTypeStateIssuer
QN703-1OtherNYORTHONET
826067OtherNYMPN
P2953214OtherNYOXFORD
4355552OtherNYMVP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
015643-1NYMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902818354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 CRYSTAL RUN RD",
            "address_2": "SUITE 104",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417000",
            "telephone_number": "845-703-3070",
            "fax_number": "745-703-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 CRYSTAL RUN RD",
            "address_2": "SUITE 104",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417000",
            "telephone_number": "845-703-3070",
            "fax_number": "745-703-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDA",
        "first_name": "SHEILA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015643-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET",
            "identifier": "QN703-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPN",
            "identifier": "826067",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2953214",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "4355552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.