Individual provider Active NPI

Renata A Zujewski, MSPT

  • Physical Therapist
  • Southington, CT
National Provider Identifier
1063466480
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006525 Issued in CT
Practice address
360 N Main St
Suite 9
Southington, CT 06489-2503
Phone
(860) 621-7389
Fax
(860) 621-2586
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006525 CT Primary

Addresses

Primary practice location

360 N Main St
Suite 9
Southington, CT 06489-2503

Mailing address

360 N Main St
Suite 9
Southington, CT 06489-2503
Phone (860) 621-7389

Other identifiers 1

IdentifierTypeStateIssuer
004252178MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050302000590 CT Practitioner - Physical Therapist in Private Practice 9638122633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ivyrehab Connecticut IncGroup PAC ID 8325203649, 71 clinicians

Practice addresses (Care Compare)

500 Chase Pkwy
FL 1
Waterbury, CT 06708-3346
Phone (203) 754-2266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006525CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. Physical Therapist CurrentSince Aug 26, 2019 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist Past Accepting new patients
Orthopedic Physical Therapy LLC Physical Therapist Past Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Sep 15, 2014 Accepting new patients

Locations

360 N Main St
Ste 9
Southington, CT 06489
Phone (860) 621-7289

101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018

500 Chase Pkwy
Fl 1
Waterbury, CT 06708
Phone (203) 754-2266

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1063466480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N MAIN ST",
            "address_2": "SUITE 9",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892503",
            "telephone_number": "860-621-7389",
            "fax_number": "860-621-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N MAIN ST",
            "address_2": "SUITE 9",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892503",
            "telephone_number": "860-621-7389",
            "fax_number": "860-621-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUJEWSKI",
        "first_name": "RENATA",
        "middle_name": "A",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004252178",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.