Active NPI
Alejandro Moises Saxton Medina
- Physical Therapist
- Trumbull, CT
National Provider Identifier
1053915181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14.012780
- Practice address
- 9113 Avalon Gates
Trumbull, CT 06611-5826 - Phone
- (973) 525-0500
- NPI assigned
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14.012780 | CT | Primary |
Addresses
Primary practice location
9113 Avalon Gates
Trumbull, CT 06611-5826
Mailing address
9113 Avalon Gates
Trumbull, CT 06611-5826
Phone (973) 525-0500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14.012780 | Other | CT | STATE LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14.012780 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1053915181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9113 AVALON GATES",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066115826",
"telephone_number": "973-525-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9113 AVALON GATES",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066115826",
"telephone_number": "973-525-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAXTON MEDINA",
"first_name": "ALEJANDRO",
"middle_name": "MOISES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "14.012780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "14.012780",
"state": "CT"
}
],
"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 Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.