Individual provider Active NPI

Srinivasa Rao Bojja

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1912889593
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054366
Practice address
3867 E Tremont Ave
Bronx, NY 10465-2479
Phone
(332) 378-5379
NPI assigned
Jul 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 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 054366 Primary

Addresses

Primary practice location

3867 E Tremont Ave
Bronx, NY 10465-2479

Mailing address

4547 158TH St
Flushing, NY 11358-3143
Phone (206) 941-5484

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104001554 NY Practitioner - Physical Therapist in Private Practice 9638669146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3867 E Tremont Ave
Bronx, NY 10465-2479
Phone (332) 246-0507

765 Burke Ave
Bronx, NY 10467-6611
Phone (347) 696-0752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054366NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Single Specialty Current Accepting new patients
Montefiore Medical Center CurrentSince Nov 3, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Nov 3, 2025 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3867 E Tremont Ave
Bronx, NY 10465
Phone (332) 246-0507

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1912889593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4547 158TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583143",
            "telephone_number": "206-941-5484",
            "fax_number": "206-941-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3867 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652479",
            "telephone_number": "332-378-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOJJA",
        "first_name": "SRINIVASA RAO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": "054366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.