Panacea Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PANACEA PHYSICAL THERAPY LLC

Practice address

50 East St N
Suffield, CT 06078-2400

Phone

(860) 726-8163

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Ahmed Moustafa Sharaf, DPTNPI 1962147306

Title

Physical Therapist

Phone

(860) 726-8163

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Panacea Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Panacea Physical Therapy LLC

  • Rehabilitation Clinic/Center
  • Enfield, CT
  • NPI 1851177265
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmed Moustafa Sharaf, DPT

  • Physical Therapist
  • Suffield, CT
  • NPI 1962147306
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1063155760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 EAST ST N",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782400",
            "telephone_number": "860-726-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 EAST ST N",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782400",
            "telephone_number": "860-726-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "SHARAF",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "MOUSTAFA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "860-726-8163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NOSH",
            "affiliation": "N",
            "endpointDescription": "NOSH",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 East St N",
            "city": "Suffield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060782400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alison Marie Nicholes, D.M.D.
• James M Noonan
• North Central Connecticut Psychotherapy
• North Central Connecticut Psychotherapy PC
• John Arpad Ostheimer, PMHNP-BC
• Jessica Park, LCSW
• Peter L. Coombs, DMD, PC
• Eric J. Peters, PHD
• Ashley Petersen
• Alix Pierce, LPC

• Physical Therapist in Suffield, CT
• Providers in Suffield, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.