Individual provider Active NPI

Taylor Benevento, MSPT

  • Physical Therapist
  • Stamford, CT
National Provider Identifier
1104424118
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12605 Issued in CT
Practice address
77 3Rd St
Stamford, CT 06905-4722
Phone
(203) 204-3092
NPI assigned
Oct 12, 2020
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 12605 CT Primary

Addresses

Primary practice location

77 3Rd St
Stamford, CT 06905-4722

Mailing address

290 Weed St
New Canaan, CT 06840-6118
Phone (917) 579-4423

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT CT, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210119000708 CT Practitioner - Physical Therapist in Private Practice 6103239819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT CT, LLCGroup PAC ID 8820235575, 76 clinicians
Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians

Practice addresses (Care Compare)

Southbury, CT 06488
Phone (877) 407-3422

1450 Whitney Ave
Hamden, CT 06517-2451
Phone (203) 208-6815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12605CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT CT, LLC Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Reliant Senior Living LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
Reliant Senior Living LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients

Locations

5800 Granite Pkwy
Ste 325
Plano, TX 75024

Organizations & group practices 3

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1104424118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 WEED ST",
            "city": "NEW CANAAN",
            "state": "CT",
            "postal_code": "068406118",
            "telephone_number": "917-579-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 3RD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069054722",
            "telephone_number": "203-204-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEVENTO",
        "first_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT CT, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "655 Main St S",
            "city": "Southbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064884220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.