Individual provider Active NPI

Travis B Lombardi, MPT

  • Physical Therapist
  • Groton, CT
National Provider Identifier
1154401305
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
772 Long Hill Rd
Groton, CT 06340-4273
Phone
(860) 326-5454
Fax
(860) 326-5502
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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 Primary

Addresses

Primary practice location

772 Long Hill Rd
Groton, CT 06340-4273

Mailing address

772 Long Hill Rd
Groton, CT 06340-4273
Phone (860) 326-5454

Other identifiers 2

IdentifierTypeStateIssuer
56080005712CT1OtherCTANTHEM BCBS PROVIDER NUM
7903503OtherCTAETNA PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000044 CT Practitioner - Physical Therapist in Private Practice 0547310617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Best Health Physical Therapy LLCGroup PAC ID 2567622863, 2 clinicians

Practice addresses (Care Compare)

428 Long Hill Rd
Suite 101
Groton, CT 06340-3811
Phone (860) 326-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Best Health Physical Therapy, LLC Physical Therapist CurrentSince Feb 21, 2012 Accepting new patients
Independence Physical Therapy, LLC Physical Therapist PastSince Jun 1, 2010 Accepting new patients

Locations

428 Long Hill Rd
Ste 101
Groton, CT 06340
Phone (860) 326-5454

772 Long Hill Rd
Groton, CT 06340
Phone (860) 326-5454

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1154401305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 LONG HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404273",
            "telephone_number": "860-326-5454",
            "fax_number": "860-326-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 LONG HILL RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404273",
            "telephone_number": "860-326-5454",
            "fax_number": "860-326-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDI",
        "first_name": "TRAVIS",
        "middle_name": "B",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER NUM",
            "identifier": "56080005712CT1",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7903503",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.