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

Vimala Thiruvengadam

Individual provider Physical Therapist · NPI 1659612257

Vimala Thiruvengadam is a Physical Therapist in Private Practice in Baldwin, New York. Qualified in 2003, 23 years ago. Practices with Sports Physical Therapy Occupational Therapy and Rehabilitation Servic, a 529-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
23
Licensed in
NY
In the registry since
2013
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Practice location Address checks out

865 Merrick Rd Ste 201
Baldwin, NY 11510-3338
Phone: (516) 444-2105
Fax: (516) 442-1056
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 036078 (NY)

Record details

NPI number1659612257
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 6, 2013
Last updated in NPPESMarch 6, 2013
Mailing address865 Merrick Road Suite#201, Baldwin, NY 11510

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Sports Physical Therapy Occupational Therapy And Rehabilitation Servic — 529 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Baldwin