NPIMap

Organization Active NPI

Ctsports Physical Therapy & Wellness LLC

  • Physical Therapy Clinic/Center
  • Norwalk, CT
National Provider Identifier
1063859320
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
008122 Issued in CT
Legal business name
CTSPORTS PHYSICAL THERAPY & WELLNESS LLC
Practice address
20 Glover Ave
Norwalk, CT 06850-1219
Phone
(617) 792-0200
NPI assigned
May 28, 2013
Last updated
Aug 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Authorized official

Name
Michael Sebastian, P.T.NPI 1841433679
Title
President
Phone
(617) 792-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 008122 CT Primary

Addresses

Primary practice location

20 Glover Ave
Norwalk, CT 06850-1219

Mailing address

20 Glover Ave
Norwalk, CT 06850-1219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130905000672 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3870736135 Receives reassigned benefits from 8 practitioners
Practice locations: Norwalk, CT

National Provider Directory

National Provider Directory

Locations

20 Glover Ave
Norwalk, CT 06850
Phone (203) 957-8100

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1063859320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GLOVER AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068501219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GLOVER AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068501219",
            "telephone_number": "617-792-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTSPORTS PHYSICAL THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-792-0200",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "008122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.