Individual provider Active NPI

Amber S Hayes, PT

  • Physical Therapist
  • Wolcott, CT
National Provider Identifier
1174863120
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
009677 Issued in CT
Practice address
465 Wolcott Rd
Advanced Physical Therapy
Wolcott, CT 06716-2613
Phone
(203) 879-0107
Fax
(203) 879-0206
NPI assigned
Feb 27, 2013
Last updated
Dec 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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 009677 CT Primary

Addresses

Primary practice location

465 Wolcott Rd
Advanced Physical Therapy
Wolcott, CT 06716-2613

Mailing address

465 Wolcott Rd
Advanced Physical Therapy
Wolcott, CT 06716-2613
Phone (203) 879-0107

Other identifiers 1

IdentifierTypeStateIssuer
009677OtherCTCONNECTICUT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000735 CT Practitioner - Physical Therapist in Private Practice 6103066501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connect Physical Therapy LLCGroup PAC ID 2163792771, 16 clinicians

Practice addresses (Care Compare)

777 Echo Lake Rd
Suite 1
Watertown, CT 06795-6617
Phone (959) 209-4318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9677CTMDClinical Social Worker
009677CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Community Physical Therapy Physical Therapist PastSince Feb 11, 2013 Accepting new patients

Locations

100 Main St N
Southbury, CT 06488
Phone (203) 262-4559

777 Echo Lake Rd
Ste 1
Watertown, CT 06795
Phone (959) 209-4318

777 Echo Lake Rd
Unit I
Watertown, CT 06795
Phone (959) 209-4318

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": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1174863120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WOLCOTT RD",
            "address_2": "ADVANCED PHYSICAL THERAPY",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162613",
            "telephone_number": "203-879-0107",
            "fax_number": "203-879-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WOLCOTT RD",
            "address_2": "ADVANCED PHYSICAL THERAPY",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162613",
            "telephone_number": "203-879-0107",
            "fax_number": "203-879-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "AMBER",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT LICENSE",
            "identifier": "009677",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wolcott, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.