Individual provider Active NPI

Neha Udeshi

  • Physical Therapist
  • Hagerstown, MD
National Provider Identifier
1952843336
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212585 Issued in VA
Practice address
14014 Marsh Pike
Hagerstown, MD 21742-1638
Phone
(301) 733-8700
NPI assigned
Nov 16, 2016
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 26195 MD
Physical Therapist 225100000X 2305212585 VA Primary

Addresses

Primary practice location

14014 Marsh Pike
Hagerstown, MD 21742-1638

Mailing address

4922 Lasalle Rd
Hyattsville, MD 20782-3302
Phone (301) 864-2333

Other identifiers 2

IdentifierTypeStateIssuer
4374045MedicaidMD
1447657507OtherMDNPI TYPE2

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200821000571 DC Practitioner - Physical Therapist in Private Practice 9638595630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Work Rehab Center, LLCGroup PAC ID 3870969397, 6 clinicians

Practice addresses (Care Compare)

4612 Kenmore Ave
Alexandria, VA 22304-1301
Phone (703) 370-1410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26195MDMDPharmacist
2305212585VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Work Rehab Center, LLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

4612 Kenmore Ave
Alexandria, VA 22304
Phone (703) 370-1410

3998 Fair Ridge Dr
Ste 100B
Fairfax, VA 22033
Phone (703) 934-0333

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": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1952843336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 LASALLE RD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207823302",
            "telephone_number": "301-864-2333",
            "fax_number": "877-828-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638",
            "telephone_number": "301-733-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDESHI",
        "first_name": "NEHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26195",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4374045",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE2",
            "identifier": "1447657507",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.