Individual provider Active NPI

John A. Crosson

  • Physical Medicine & Rehabilitation Physician
  • Suffield, CT
National Provider Identifier
1104614361
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
004657 Issued in CT
Practice address
226 Mountain Rd
Suffield, CT 06078-2082
Phone
(860) 901-2097
Fax
(860) 899-1050
NPI assigned
Apr 28, 2025
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 004657 CT Primary

Addresses

Primary practice location

226 Mountain Rd
Suffield, CT 06078-2082

Mailing address

226 Mountain Rd
Suffield, CT 06078-2082
Phone (860) 965-5523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250612003205 CT Practitioner - Physical Therapist in Private Practice 1658882196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
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)

226 Mountain Rd
Suffield, CT 06078-2082
Phone (860) 901-2097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004657CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Connecticut, Inc. CurrentSince Apr 21, 2025 Accepting new patients

Locations

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

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

Organizations & group practices 1

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1104614361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MOUNTAIN RD",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782082",
            "telephone_number": "860-965-5523",
            "fax_number": "860-899-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MOUNTAIN RD",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782082",
            "telephone_number": "860-901-2097",
            "fax_number": "860-899-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSON",
        "first_name": "JOHN",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "004657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.