Bianca Bolduc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11191 Issued in CT

Practice address

17 Commons Dr
Unit 6
Litchfield, CT 06759

Phone

(203) 417-5864

NPI assigned

Nov 8, 2016

Last updated

Jul 9, 2025By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bloom Pediatric Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Litchfield, CT
  • NPI 1114818002
  NPD Authorized official
• Cheshire Fitness Zone, LLC

  • Pediatric Physical Therapist
  • Cheshire, CT
  • NPI 1205961547
  NPD
• The Hailey Mayz Foundation

  dba Amayzing Kids

  • Speech-Language Pathologist
  • Ranch Santa Margarita, CA
  • NPI 1023309390
  NPD (past)

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1275075285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 MAPLE VIEW TRL",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "067592125",
            "telephone_number": "203-417-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 COMMONS DR",
            "address_2": "UNIT 6",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "06759",
            "telephone_number": "203-417-5864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24422 Avenida De La Carlota Ste 100",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "92653",
            "country_code": "US",
            "telephone_number": "949-916-1654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29977 Avenida De Las Bandera",
            "address_purpose": "LOCATION",
            "city": "Rancho Santa Margarita",
            "state": "CA",
            "postal_code": "926882113",
            "country_code": "US",
            "telephone_number": "949-600-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "382 S Main St",
            "address_purpose": "LOCATION",
            "city": "Cheshire",
            "state": "CT",
            "postal_code": "06410",
            "country_code": "US",
            "telephone_number": "203-250-9663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24422 Avenida De La Carlota Ste 100",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "92653",
            "country_code": "US",
            "telephone_number": "949-916-1654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Tompkins St",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067081458",
            "country_code": "US",
            "telephone_number": "203-419-0381",
            "fax_number": "203-419-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDUC",
        "first_name": "BIANCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-08",
        "last_updated": "2025-07-09",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293176",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "11191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004190328",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloom Pediatric Therapy, PLLC
• Lauren J Blouin, CCC-SLP
• Blue Heron Health LLC
• Boden Counseling LLC
• Candace I Boden, LCSW
• Michael A Bosson, L.O.
• Alexis C. Bouteneff, M.D.
• Catherine Anne Buckingham, LMSW
• Edward R Burns, LMFT STATE OF CT
• Renee T Case, CCC-SLP

• Physical Therapist in Litchfield, CT
• Providers in Litchfield, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.