Individual provider Active NPI

Sarah Jendza, PT

  • Physical Therapist
  • Glastonbury, CT
National Provider Identifier
1104299395
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10723 Issued in CT
Practice address
2520 Main St
Glastonbury, CT 06033-4250
Phone
(860) 430-8383
Fax
(860) 856-6945
NPI assigned
Nov 10, 2015
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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 10723 CT Primary

Addresses

Primary practice location

2520 Main St
Glastonbury, CT 06033-4250

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (142) 944-0509

Other practice location 1

515 Middle Tpke W
Manchester, CT 06040-3816
Phone (860) 533-4480

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160122001001 CT Practitioner - Physical Therapist in Private Practice 5193028231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Connecticut IncGroup PAC ID 8325203649, 71 clinicians

Practice addresses (Care Compare)

2520 Main St
Suite B
Glastonbury, CT 06033-4250
Phone (860) 430-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. Physical Therapist CurrentSince Nov 22, 2021 Accepting new patients
Prohealth Physicians PC Physical Therapist CurrentSince Nov 16, 2015 Accepting new patients

Locations

2520 Main St
Ste B
Glastonbury, CT 06033
Phone (860) 430-8383

515 Middle Tpke W
Manchester, CT 06040
Phone (860) 533-4176

226 Mountain Rd
Suffield, CT 06078
Phone (860) 901-2097

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

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1104299395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "142-944-0509",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334250",
            "telephone_number": "860-430-8383",
            "fax_number": "860-856-6945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Middle Tpke W",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060403816",
            "country_code": "US",
            "telephone_number": "860-533-4480",
            "fax_number": "860-643-9057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENDZA",
        "first_name": "SARAH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.