Individual provider Active NPI

Jason A White, DPT

  • Physical Therapist
  • Westport, CT
National Provider Identifier
1295096196
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14.009619 Issued in CT
Practice address
333 Post Rd W
Westport, CT 06880-4701
Phone
(203) 422-0679
Fax
(203) 422-0913
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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 14.009619 CT Primary

Addresses

Primary practice location

333 Post Rd W
Westport, CT 06880-4701

Mailing address

35 River Rd
Cos Cob, CT 06807-2759
Phone (203) 422-0679

Other identifiers 2

IdentifierTypeStateIssuer
080009619CT02OtherCTANTHEM BLUECROSS & BLUESHIELD
8049282MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130204000521 CT Practitioner - Physical Therapist in Private Practice 2365696028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT CT, LLCGroup PAC ID 8820235575, 76 clinicians

Practice addresses (Care Compare)

Southbury, CT 06488
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14.009619CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT CT, LLC Physical Therapist CurrentSince Feb 27, 2017 Accepting new patients
Greenwich Sports Medicine at Twin Rinks LLC PastSince Jan 21, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1295096196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RIVER RD",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072759",
            "telephone_number": "203-422-0679",
            "fax_number": "203-422-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804701",
            "telephone_number": "203-422-0679",
            "fax_number": "203-422-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JASON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14.009619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUECROSS & BLUESHIELD",
            "identifier": "080009619CT02",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8049282",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.