Individual provider Active NPI

Teresa M Guadagno, PT

  • Physical Therapist
  • Bethel, CT
National Provider Identifier
1063785319
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003954 Issued in CT
Practice address
13 Park Lawn Dr
Bethel, CT 06801-1043
Phone
(203) 830-4180
NPI assigned
Feb 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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 003954 CT Primary

Addresses

Primary practice location

13 Park Lawn Dr
Bethel, CT 06801-1043

Mailing address

13 Park Lawn Dr
Bethel, CT 06801-1043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240223001517 CO Practitioner - Physical Therapist in Private Practice 4688018179 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003954CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 14, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 14, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Feb 14, 2024 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist Past Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Sep 15, 2014 Accepting new patients

Locations

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

501 S Cherry St
Fl 11
Denver, CO 80246
Phone (309) 530-8782

8550 W 38th Ave
Ste 100
Wheat Ridge, CO 80033
Phone (303) 467-4100

Organizations & group practices 5

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": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1063785319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 PARK LAWN DR",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 PARK LAWN DR",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011043",
            "telephone_number": "203-830-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADAGNO",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "003954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.