Serena Ann Magnan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0400003365 Issued in VT

Practice address

300 Cornerstone Drive
Ste 315
Williston, VT 05495

Phone

(802) 878-3600

Fax

(802) 879-3041

NPI assigned

Nov 16, 2006

Last updated

Apr 8, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Vermont College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy Center of Vermont LLCGroup PAC ID 2163442138, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Physical Therapy Center of Vermont LLC

  dba The Edge Physical Therapy

  • Physical Therapist
  • South Burlington, VT
  • NPI 1700919818
  Medicare reassignment Care Compare group
• Cornerstone Physical Therapy

  • Physical Therapist
  • Williston, VT
  • NPI 1821161720
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239148800000",
    "number": "1215000112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CORNERSTONE DRIVE",
            "address_2": "STE 315",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "05495",
            "telephone_number": "802-878-3600",
            "fax_number": "802-879-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CORNERSTONE DRIVE",
            "address_2": "STE 315",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "05495",
            "telephone_number": "802-878-3600",
            "fax_number": "802-879-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNAN",
        "first_name": "SERENA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400003365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2532",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58035",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anastasiya Lulic, FNP
• Sagui Lutman, OTR
• Lux Telepsych PLC (Jessica Jawidzik)
• Sarah Maas, PSY. MA
• Kaeli A. Mace, PT
• Owen David Maguire, MD
• Mainspring Health, Inc.
• Moriah Constance Manahan
• Stephen E Mann, MD
• Nicholas Paul Marconi, O.D.

• Physical Therapist in Williston, VT
• Providers in Williston, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.