Stephanie Genest, PT, DPT, CSCS
Individual provider Active NPI Physical Therapist · Prospect, CT
NPI 1104379874 · NPPES record last updated Aug 7, 2024
Key facts
- NPI
- 1104379874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11053 (CT)
- Practice address
- 151 Matthew St
Prospect, CT 06712-1415 - Phone
- (860) 307-9198
- NPI assigned
- Jul 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Connect Physical Therapy LLC
Practice addresses (Care Compare)
777 Echo Lake Rd
Suite 1
Watertown, CT 06795-6617
Phone (959) 209-4318
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160919001328 | CT | Practitioner - Physical Therapist in Private Practice | 9234426214 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Elevation Performance and Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
3 Simm Ln
Newtown, CT 06470
Phone (860) 307-9189
123 Union City Rd
Unit 2
Prospect, CT 06712
Phone (959) 209-4318
100 Main St N
Southbury, CT 06488
Phone (203) 262-4559
777 Echo Lake Rd
Ste 1
Watertown, CT 06795
Phone (959) 209-4318
777 Echo Lake Rd
Unit I
Watertown, CT 06795
Phone (959) 209-4318
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11053 | CT | Yes |
Addresses
Primary practice location
151 Matthew St
Prospect, CT 06712-1415
Mailing address
151 Matthew St
Prospect, CT 06712-1415
Phone (860) 307-9198
Other providers in Prospect, CT
- Full Spectrum Therapeutics LLC
- Leonard J Fusco
- Laura Galindo
- Laurie L Gambardella
- Catherine Gelinas
- Karl Benjamin Genovese
- Christy Ann George
- Kathleen Golebiewski
- Laurene M. Gomez
- Tonya Goodman
All providers in Prospect, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.