Individual provider Active NPI

Kirat Shah, PT,MPT,CWS,CLT-LANA

  • Physical Therapist
  • Glen Allen, VA
National Provider Identifier
1942697602
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305206253 Issued in VA
Practice address
2916 Ridgegate PL
Glen Allen, VA 23059-4682
Phone
(517) 918-4849
NPI assigned
Apr 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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 2305206253 VA Primary

Addresses

Primary practice location

2916 Ridgegate PL
Glen Allen, VA 23059-4682

Mailing address

2916 Ridgegate PL
Glen Allen, VA 23059-4682
Phone (517) 918-4849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170103001667 VA Practitioner - Physical Therapist in Private Practice 5395026611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lymphedema and Rehabilitation Consultants PLLCGroup PAC ID 0648551952, 2 clinicians

Practice addresses (Care Compare)

2916 Ridgegate PL
Glen Allen, VA 23059-4682
Phone 51791848491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lymphedema and Rehabilitation Consultants ,PLLC Physical Therapist CurrentSince Sep 14, 2016 Accepting new patients

Locations

3660 Boulevard
Ste J
Colonial Hgts, VA 23834
Phone (804) 288-1953

8237 Meadowbridge Rd
Mechanicsville, VA 23116
Phone (804) 288-1953

Organizations & group practices 1

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1942697602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 RIDGEGATE PL",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594682",
            "telephone_number": "517-918-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 RIDGEGATE PL",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594682",
            "telephone_number": "517-918-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KIRAT",
        "name_prefix": "Mr.",
        "credential": "PT,MPT,CWS,CLT-LANA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.