NPIMap

Organization Active NPI

Crescent Moon Care LLC

  • Physical Therapist
  • Canton, CT
National Provider Identifier
1174108393
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CRESCENT MOON CARE LLC
Practice address
259 Albany Tpke Ste 5
Canton, CT 06019-2557
Phone
(203) 788-0009
NPI assigned
Mar 10, 2021
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Janell TartagliaNPI 1104109867
Title
Owner
Phone
(203) 788-0009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

259 Albany Tpke Ste 5
Canton, CT 06019-2557

Mailing address

61 Park Rd
Barkhamsted, CT 06063-4119

National Provider Directory

National Provider Directory

Locations

259 Albany Tpke
Ste 5
Canton, CT 06019
Phone (203) 788-0009

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1174108393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 PARK RD",
            "city": "BARKHAMSTED",
            "state": "CT",
            "postal_code": "060634119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 ALBANY TPKE STE 5",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192557",
            "telephone_number": "203-788-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MOON CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "TARTAGLIA",
        "authorized_official_first_name": "JANELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-788-0009"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.