Individual provider Active NPI

Anne Wolf, P.T.

  • Physical Therapist
  • Trumbull, CT
National Provider Identifier
1033543285
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6316 Issued in CT
Practice address
115 Technology Dr
Trumbull, CT 06611-6337
Phone
(203) 856-5460
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2015

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 6316 CT Primary
Neurology Physician 2084N0400X 6316 CT

Addresses

Primary practice location

115 Technology Dr
Trumbull, CT 06611-6337

Mailing address

75 Rosemere Ave
Fairfield, CT 06825-1734
Phone (203) 856-5460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924001013 CT Practitioner - Physical Therapist in Private Practice 2769790765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6527 Main St
Lowr Level
Trumbull, CT 06611-1385
Phone (203) 856-5460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6316CTMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Dynamics PT LLC Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients

Locations

6527 Main St
Lowr
Trumbull, CT 06611
Phone (203) 414-1292

Organizations & group practices 1

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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1033543285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ROSEMERE AVE",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068251734",
            "telephone_number": "203-856-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TECHNOLOGY DR",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116337",
            "telephone_number": "203-856-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ANNE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "6316",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "6316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.