Individual provider Active NPI

Dale L Sweet Jr., PHYSICAL THERAPIST

  • Physical Therapist
  • Thomaston, CT
National Provider Identifier
1194705780
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10 Marine St
Thomaston, CT 06787-1470
Phone
(860) 283-2316
Fax
(860) 283-6079
NPI assigned
Jan 19, 2006
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 NU Primary

Addresses

Primary practice location

10 Marine St
Thomaston, CT 06787-1470

Mailing address

10 Marine St
Thomaston, CT 06787-1470
Phone (860) 283-2316

Other identifiers 3

IdentifierTypeStateIssuer
6109OtherCTLICENSE
ANTHEM BC/BSOtherCTPROVIDER ID NUMBER
004190758MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309000466 CT Practitioner - Physical Therapist in Private Practice 4385532548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomaston Physical Therapy, LLCGroup PAC ID 2264487701, 2 clinicians

Practice addresses (Care Compare)

10 Marine St
Thomaston, CT 06787-1470
Phone (860) 283-2316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006109CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomaston Physical Therapy, LLC Physical Therapist CurrentSince Feb 1, 2005 Accepting new patients

Locations

10 Marine St
Thomaston, CT 06787
Phone (860) 283-2316

258 S Main St
Thomaston, CT 06787
Phone (860) 283-2316

Organizations & group practices 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1194705780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARINE ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871470",
            "telephone_number": "860-283-2316",
            "fax_number": "860-283-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARINE ST",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871470",
            "telephone_number": "860-283-2316",
            "fax_number": "860-283-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEET",
        "first_name": "DALE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6109",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID NUMBER",
            "identifier": "ANTHEM BC/BS",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004190758",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.