Individual provider Active NPI

Ambika Devacaanthan, MSPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1922148337
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 030235 Issued in NY
Practice address
317 W 82ND St
Apt 2a
New York, NY 10024-5335
Phone
(954) 684-8234
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 21181 FL
Physical Therapist 225100000X PT 030235 NY Primary
Physical Therapist 225100000X 22 030235 NY

Addresses

Primary practice location

317 W 82ND St
Apt 2a
New York, NY 10024-5335

Mailing address

317 W 82ND St
Apt 2a
New York, NY 10024-5335
Phone (954) 684-8234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090401000154 NY Practitioner - Physical Therapist in Private Practice 6608933965 Reassigns benefits to 1 organization
I20200618001110 FL Practitioner - Physical Therapist in Private Practice 6608933965

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

317 W 82ND St
New York, NY 10024-5335
Phone (954) 684-8234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 21181FLMDPhysical Therapist
22 030235NYMDPhysical Therapist
PT 030235NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Rehab and Home Care PT & OT, PLLC Physical Therapist CurrentSince Jan 15, 2013 Accepting new patients
Deva Physical Therapy LLC Physical Therapist CurrentSince Nov 3, 2011 Accepting new patients

Locations

7901 4th St N
Ste 300
St Petersburg, FL 33702
Phone (305) 204-3616

143 E Ridgewood Ave
Unit 309
Ridgewood, NJ 07451

Organizations & group practices 2

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1922148337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W 82ND ST",
            "address_2": "APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245335",
            "telephone_number": "954-684-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W 82ND ST",
            "address_2": "APT 2A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245335",
            "telephone_number": "954-684-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVACAANTHAN",
        "first_name": "AMBIKA",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21181",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "PT 030235",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "22  030235",
            "primary": false
        }
    ],
    "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 Oct 3, 2011; 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.