Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andi Bala, PT, DPT

Individual provider Physical Therapist · NPI 1104770890

Andi Bala, PT, DPT is a Physical Therapist in Private Practice in Ridgewood, New York. Qualified in 2025, 1 year ago. Practices with Sports Physical Therapy Occupational Therapy and Rehabilitation Servic, a 529-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2026
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

5505 Myrtle Ave
Ridgewood, NY 11385-3550
Phone: (347) 408-2387
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1104770890
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedFebruary 21, 2026
Last updated in NPPESFebruary 21, 2026
Certification dateFebruary 20, 2026
Mailing address102 Madison Ave Fl 8, New York, NY 10016-7584

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Sports Physical Therapy Occupational Therapy And Rehabilitation Servic — 529 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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