Jenalyn D Vergara, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

008043 Issued in CT

Practice address

186 Jerry Browne Rd
Mystic, CT 06355-4004

Phone

(860) 572-5675

NPI assigned

Sep 18, 2018

Last updated

Sep 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inspire Physical Therapy and Wellness, LLCGroup PAC ID 4688073448, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Inspire Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Westerly, RI
  • NPI 1548847221

  CT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1083198790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ENSIGN DR",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551530",
            "telephone_number": "631-882-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 JERRY BROWNE RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554004",
            "telephone_number": "860-572-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "JENALYN",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasey McKenzie Vallee, OTR/L
• Value in Prevention of Connecticut PLLC
• Tracy M Van Vught, P.T.
• Kristi R Varisco, L.P.C.
• Lisa Venditto, MA
• Visions Sight & Learning Center
• Linda Vogel, PH.D.
• Wade Lindsay Chartier Ma Ladc
• Wagner Industries, Inc. (OptiMystic)
• Thomas Jeffrey Wagner, OD MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.