Individual provider Active NPI

Maria I Moreno, PT

  • Physical Therapist
  • Middletown, CT
National Provider Identifier
1053455337
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4956 Issued in CT
Practice address
410 Saybrook Rd Ste 100
Middletown, CT 06457-4780
Phone
(860) 638-3820
Fax
(860) 638-3840
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 4956 CT
Physical Therapist 225100000X 4956 CT Primary
Hand Physical Therapist 2251H1200X 4956 CT
Pediatric Physical Therapist 2251P0200X 4956 CT
Sports Physical Therapist 2251S0007X 4956 CT
Orthopedic Physical Therapist 2251X0800X 4956 CT

Addresses

Primary practice location

410 Saybrook Rd Ste 100
Middletown, CT 06457-4780

Mailing address

410 Saybrook Rd Ste 100
Middletown, CT 06457-4780
Phone (860) 638-3820

Other identifiers 8

IdentifierTypeStateIssuer
64-04254OtherCTUNITED HEALTHCARE
712712OtherCTCONNECTICARE
OV1691OtherCTHEALTHNET
004175114MedicaidCT
A667399OtherCTOXFORD
080004956CT03OtherCTANTHEM BCBS
114175114-00OtherCTBLUE CARE FAMILY PLAN
3372505OtherCTAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110124000325 CT Practitioner - Physical Therapist in Private Practice 6608055603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.55
Promoting interoperability
100
Improvement activities
40
Cost
64.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4956CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Orthopedic Surgeons PC Orthopedic CurrentSince Jun 1, 2015 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Dec 1, 2021 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Rpat, Inc Past Accepting new patients

Locations

6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145

117 Main St
Hebron, CT 06248
Phone (860) 228-3888

430 Saybrook Rd
Middletown, CT 06457
Phone (860) 638-3820

512 Saybrook Rd
Ste 100
Middletown, CT 06457
Phone (860) 704-6021

410 Saybrook Rd
Ste 100
Middletown, CT 06457
Phone (860) 685-8951

161 Cross St
Middletown, CT 06459
Phone (860) 685-3528

4 Grove Beach Rd N
Ste E
Westbrook, CT 06498

Organizations & group practices 4

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1053455337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-638-3820",
            "fax_number": "860-638-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574780",
            "telephone_number": "860-638-3820",
            "fax_number": "860-638-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARIA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CT",
            "license": "4956",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "4956",
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "CT",
            "license": "4956",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CT",
            "license": "4956",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CT",
            "license": "4956",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "4956",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "64-04254",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "712712",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OV1691",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004175114",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A667399",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "080004956CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN",
            "identifier": "114175114-00",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3372505",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.