Active NPI
Stephanie Anne Brusseau, PT, MS, DPT
- Physical Therapist
- Springfield, MA
National Provider Identifier
1134574833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17373
- Practice address
- 300 Birnie Ave
Suite 303
Springfield, MA 01107-1107 - Phone
- (413) 575-2284
- NPI assigned
- Apr 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17373 | MA | Primary |
Addresses
Primary practice location
300 Birnie Ave
Suite 303
Springfield, MA 01107-1107
Mailing address
300 Birnie Ave
Suite 303
Springfield, MA 01107-1107
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17373 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461974400000",
"number": "1134574833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BIRNIE AVE",
"address_2": "SUITE 303",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BIRNIE AVE",
"address_2": "SUITE 303",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071107",
"telephone_number": "413-575-2284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSSEAU",
"first_name": "STEPHANIE",
"middle_name": "ANNE",
"credential": "PT, MS, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-30",
"last_updated": "2016-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.