Individual provider Active NPI

Runzun Shetye, DPT

  • Physical Therapist
  • Burlington, MA
National Provider Identifier
1972755510
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18212 Issued in MA
Practice address
3 Burlington Woods
Suite 304
Burlington, MA 01803-4514
Phone
(781) 270-0222
NPI assigned
Oct 15, 2008
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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 18212 MA Primary

Addresses

Primary practice location

3 Burlington Woods
Suite 304
Burlington, MA 01803-4514

Mailing address

1412 Mara Vista CT
Crofton, MD 21114-1132
Phone (339) 545-6361

Other identifiers 1

IdentifierTypeStateIssuer
18212OtherMALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210809002394 MD Practitioner - Physical Therapist in Private Practice 2163826447 Reassigns benefits to 2 organizations
I20210809002628 DC Practitioner - Physical Therapist in Private Practice 2163826447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Annapolis Lymphedema CenterGroup PAC ID 4284605288, 4 clinicians

Practice addresses (Care Compare)

2525 Riva Rd
Suite 130
Annapolis, MD 21401-7437
Phone (410) 266-8010

Merit-based Incentive Payment System (MIPS)

Final score
53.6 of 100Reported as individual
Quality
23.54
Promoting interoperability
98
Improvement activities
30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18212MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Aug 2, 2021 Accepting new patients
Annapolis Lymphedema Center Physical Therapist CurrentSince Jan 7, 2025 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

2001 Medical Pkwy
Ofc
Annapolis, MD 21401
Phone (443) 481-1091

2525 Riva Rd
Ste 130
Annapolis, MD 21401
Phone (410) 266-8010

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 5

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1972755510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MARA VISTA CT",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141132",
            "telephone_number": "339-545-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BURLINGTON WOODS",
            "address_2": "SUITE 304",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034514",
            "telephone_number": "781-270-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETYE",
        "first_name": "RUNZUN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2021-09-21",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "18212",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.