Individual provider Active NPI

Stephen Giblin, DPT

  • Physical Therapist
  • North Haven, CT
National Provider Identifier
1104461854
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12482 Issued in CT
Practice address
202 State St
North Haven, CT 06473-2207
Phone
(203) 239-4274
Fax
(203) 239-4290
NPI assigned
Nov 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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 12482 CT Primary

Addresses

Primary practice location

202 State St
North Haven, CT 06473-2207

Mailing address

202 State St
North Haven, CT 06473-2207
Phone (203) 239-4274

Other practice location 1

2334 Whitney Ave
Hamden, CT 06518-3506
Phone (203) 248-8645

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124002133 CT Practitioner - Physical Therapist in Private Practice 9234564022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quinnipiac Physical Therapy and Sports Medicine PCGroup PAC ID 6103811930, 4 clinicians

Practice addresses (Care Compare)

2334 Whitney Ave
Hamden, CT 06518-3506
Phone (203) 248-8645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quinnipiac Physical Therapy & Sports Medicine PC Physical Therapist CurrentSince Jan 2, 2020 Accepting new patients
Montowese Chiropractic Center LLC PastSince Nov 17, 2019 Accepting new patients

Locations

2334 Whitney Ave
Hamden, CT 06518
Phone (203) 248-8645

202 State St
North Haven, CT 06473
Phone (203) 239-4274

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1104461854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732207",
            "telephone_number": "203-239-4274",
            "fax_number": "203-239-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732207",
            "telephone_number": "203-239-4274",
            "fax_number": "203-239-4290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2334 Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065183506",
            "country_code": "US",
            "telephone_number": "203-248-8645",
            "fax_number": "203-248-8350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBLIN",
        "first_name": "STEPHEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.