Summit Rehab Consultants PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SUMMIT REHAB CONSULTANTS PLLC

Practice address

164 Home Acres Ave
Milford, CT 06460-3518

Phone

(607) 329-3645

NPI assigned

Oct 2, 2019

Organization subpart

No

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

Authorized official

Name

Casey Keenan, PA-CNPI 1992093603

Title

Co-Owner

Phone

(607) 329-3645

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Casey Keenan

  • Medical Physician Assistant
  • Bridgeport, CT
  • NPI 1992093603
  Medicare reassignment Authorized official
• Michael Paul Betler, DO

  • Physical Medicine & Rehabilitation Physician
  • Westport, CT
  • NPI 1407158108
  Medicare reassignment
• Anupama Kurra, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Milford, CT
  • NPI 1871728972
  Medicare reassignment
• Christine M Needham, APRN

  • Acute Care Nurse Practitioner
  • Bridgeport, CT
  • NPI 1366828907
  Medicare reassignment

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1104467943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 HOME ACRES AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 HOME ACRES AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603518",
            "telephone_number": "607-329-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT REHAB CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "607-329-3645",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "medical practice email and emr's",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "164 Home Acres Ave",
            "city": "Milford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064603518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Milford, CT
• Providers in Milford, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.