Individual provider Active NPI

Namita Kantawala

  • Physical Therapist
  • Birmingham, AL
National Provider Identifier
1992239586
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5431 Patrick Way Suite 101
Birmingham, AL 35235-3934
Phone
(205) 508-2277
Fax
(205) 997-2117
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 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 26331 MD
Physical Therapist 225100000X AL Primary

Addresses

Primary practice location

5431 Patrick Way Suite 101
Birmingham, AL 35235-3934

Mailing address

790 Remington Blvd,
Boolingbrook, IL 60440

Other practice location 1

416 E 30th St
Baltimore, MD 21218-3934
Phone (410) 889-0727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, AL, CT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20170524000303 MD Practitioner - Physical Therapist in Private Practice 3476820424
I20240715001518 AL Practitioner - Physical Therapist in Private Practice 3476820424 Reassigns benefits to 1 organization
I20260122002204 CT Practitioner - Physical Therapist in Private Practice 3476820424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

416 E 30TH St
Baltimore, MD 21218-3934

47 N Main St
West Hartford, CT 06107-1926

Merit-based Incentive Payment System (MIPS)

Final score
86.04 of 100Reported as group
Quality
90
Improvement activities
40
Cost
71.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14884CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients
Ati Holdings of Alabama, LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

5431 Patrick Way
Ste 101
Birmingham, AL 35235
Phone (205) 508-2277

1877 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 727-1701

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

790 Remington Blvd
Bolingbrook, IL 60440

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1992239586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD,",
            "city": "BOOLINGBROOK",
            "state": "IL",
            "postal_code": "60440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5431 PATRICK WAY SUITE 101",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353934",
            "telephone_number": "205-508-2277",
            "fax_number": "205-997-2117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 E 30th St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212183934",
            "country_code": "US",
            "telephone_number": "410-889-0727",
            "fax_number": "410-889-0729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANTAWALA",
        "first_name": "NAMITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26331",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.