Active NPI
Shruti Anvay Pradhan, PT, DPT, MS
- Physical Therapist
- Sarasota, FL
National Provider Identifier
1992161194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 30996
- Practice address
- 4630 17TH St
Sarasota, FL 34235-1843 - Phone
- (941) 993-9249
- NPI assigned
- Jan 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | PT 30996 | FL | |
| Physical Therapist | 225100000X | PT 30996 | FL | Primary |
Addresses
Primary practice location
4630 17TH St
Sarasota, FL 34235-1843
Mailing address
4630 17TH St
Sarasota, FL 34235-1843
Phone (941) 993-9249
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016465400 | Medicaid | FL |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 30996 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1992161194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4630 17TH ST",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342351843",
"telephone_number": "941-993-9249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4630 17TH ST",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342351843",
"telephone_number": "941-993-9249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRADHAN",
"first_name": "SHRUTI",
"middle_name": "ANVAY",
"credential": "PT, DPT, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-05",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "PT 30996",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 30996",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016465400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.