Individual provider Active NPI

Anjelia Altebrando, DPT

  • Physical Therapist
  • Cranston, RI
National Provider Identifier
1124858782
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT03859 Issued in RI
Practice address
1 New London Ave Unit 9
Cranston, RI 02920-5600
Phone
(401) 205-8200
Fax
(401) 250-5724
NPI assigned
Aug 7, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 PT03859 RI Primary

Addresses

Primary practice location

1 New London Ave Unit 9
Cranston, RI 02920-5600

Mailing address

4 Richmond SQ Ste 200
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001730 RI Practitioner - Physical Therapist in Private Practice 5092253518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians

Practice addresses (Care Compare)

1 New London Ave
Cranston, RI 02920-5600
Phone (401) 726-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Aug 6, 2024 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Aug 11, 2024 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Aug 6, 2024 Accepting new patients

Locations

1 New London Ave
Cranston, RI 02920
Phone (401) 205-8200

1 New London Ave
Unit 9
Cranston, RI 02920
Phone (401) 205-8200

4 Richmond Sq
Ste 200
Providence, RI 02906

41 Sanderson Rd
Ste 101
Smithfield, RI 02917
Phone (401) 349-4540

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1124858782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NEW LONDON AVE UNIT 9",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205600",
            "telephone_number": "401-205-8200",
            "fax_number": "401-250-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTEBRANDO",
        "first_name": "ANJELIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT03859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.