Active NPI
Komal Gummadivally
- Physical Therapist
- Franklin Square, NY
National Provider Identifier
1962287532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 050651
- Practice address
- 820 Hemstead Turnpike
Franklin Square, NY 11010 - Phone
- (516) 440-2277
- Fax
- (516) 358-8960
- NPI assigned
- Aug 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 050651 | NY | Primary |
Addresses
Primary practice location
820 Hemstead Turnpike
Franklin Square, NY 11010
Mailing address
179 7TH St
Hicksville, NY 11801-5429
Phone (316) 300-6972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050651 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One on One Physical Therapy Services PLLC | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Brooklyn, NY
- NPI 1740423219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1962287532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 7TH ST",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118015429",
"telephone_number": "316-300-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 HEMSTEAD TURNPIKE",
"city": "FRANKLIN SQUARE",
"state": "NY",
"postal_code": "11010",
"telephone_number": "516-440-2277",
"fax_number": "516-358-8960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUMMADIVALLY",
"first_name": "KOMAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-30",
"last_updated": "2023-08-30",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "050651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Franklin Square, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.