Individual provider Active NPI

Priti Pravin Shinde

  • Physical Therapist
  • New York, NY
National Provider Identifier
1912543984
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02069300 Issued in NJ
Practice address
240 E 54TH St
New York, NY 10022-5286
Phone
(212) 371-7001
NPI assigned
Nov 25, 2019
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 012275 CT
Physical Therapist 225100000X 11166298-2401 UT
Physical Therapist 225100000X 045009-01 NY
Physical Therapist 225100000X 40QA02069300 NJ Primary

Addresses

Primary practice location

240 E 54TH St
New York, NY 10022-5286

Mailing address

220 Harmon Cove Tower
Secaucus, NJ 07094-1729
Phone (917) 935-7155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200103000477 NY Practitioner - Physical Therapist in Private Practice 4880028661
I20220614000318 NJ Practitioner - Physical Therapist in Private Practice 4880028661 Reassigns benefits to 4 organizations

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
Advanced Ortho and Pain Center IncGroup PAC ID 7315327723, 3 clinicians

Practice addresses (Care Compare)

550 Newark Ave
Suite 304
Jersey City, NJ 07306-1356
Phone (201) 624-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045009NYMDPharmacist
012275CTMDPhysical Therapist
40QA02069300NJMDPhysical Therapist
045009-01NYMDPhysical Therapist
11166298-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Rehab Somerset PA CurrentSince May 4, 2022 Accepting new patients
Advanced Ortho & Pain Center Inc Physical Therapist CurrentSince Feb 15, 2025 Accepting new patients
Trinity Rehab Somerset PA Physical Therapist Current Accepting new patients
Trinity Rehab Somerset PA CurrentSince May 4, 2022 Accepting new patients
Advanced Garden State Cardiology LLC CurrentSince Oct 2, 2025 Accepting new patients
Sportsmed PT LLC Physical Therapist CurrentSince Sep 21, 2023 Accepting new patients

Locations

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5905

550 Newark Ave
Ste 304
Jersey City, NJ 07306
Phone (201) 222-1400

550 Newark Ave
Ste 307
Jersey City, NJ 07306
Phone (201) 418-9111

328 Newman Springs Rd
Ste 10
Red Bank, NJ 07701

175 Route 37 W
#R
Toms River, NJ 08755

211 Berdan Ave
Wayne, NJ 07470
Phone (201) 249-6930

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GGAICD

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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1912543984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HARMON COVE TOWER",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070941729",
            "telephone_number": "917-935-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E 54TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225286",
            "telephone_number": "212-371-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDE",
        "first_name": "PRITI PRAVIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "012275",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "11166298-2401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045009-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02069300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.