Michelle B Mazzarella, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

005730 Issued in CT

Practice address

435 Hartford Tpke Ste U
Vernon Rockville, CT 06066-4834

Phone

(860) 870-8272

NPI assigned

Nov 12, 2006

Last updated

May 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle B Mayer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Rehabilitation Services Limited Partnership

  • Physical Therapist
  • Vernon, CT
  • NPI 1346969532
  NPD

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1073684148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HARTFORD TPKE STE U",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060664834",
            "telephone_number": "860-870-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HARTFORD TPKE STE U",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060664834",
            "telephone_number": "860-870-8272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "534 Saybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "064574754",
            "country_code": "US",
            "telephone_number": "860-358-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZZARELLA",
        "first_name": "MICHELLE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "005730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MAYER",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Vernon Rockville, CT
• Providers in Vernon Rockville, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; 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.