Elizabeth Gross, PT
Individual provider Active NPI Physical Therapist · Pawcatuck, CT
NPI 1104881812 · NPPES record last updated Feb 21, 2008
Key facts
- NPI
- 1104881812
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 004925 (CT)
- Practice address
- 158 South Broad Street
Pawcatuck, CT 06379-1925 - Phone
- (860) 599-0819
- Fax
- (860) 599-0871
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
158 S Broad St
Pawcatuck, CT 06379-3961
Phone (860) 599-0819
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230815001154 | CT | Practitioner - Physical Therapist in Private Practice | 3577649458 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
158 S Broad St
Pawcatuck, CT 06379
Phone (860) 535-0440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004925 | CT | Yes |
Addresses
Primary practice location
158 South Broad Street
Pawcatuck, CT 06379-1925
Mailing address
158 South Broad Street
Pawcatuck, CT 06379-1925
Phone (860) 599-0819
Other providers in Pawcatuck, CT
- Mercy Etzel
- Kristen Fernandez
- John Michael Flaherty
- Golden Heart Care Services LLC
- Abrielle Gouvin
- Nora J Gumpel
- Taylor Mackenzie Hanes
- Katharine Headley
- Sara W Hewson
- HHHH Care LLC
All providers in Pawcatuck, 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 Feb 21, 2008. 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.