Stacey Stark
Individual provider Active NPI Physical Therapist · North Franklin, CT
NPI 1306956073 · NPPES record last updated Nov 26, 2012
Key facts
- NPI
- 1306956073
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 82 New Park Ave
North Franklin, CT 06254-1807 - Phone
- (860) 823-6221
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Norwich Orthopedic Group PC
Practice addresses (Care Compare)
82 New Park Ave
North Franklin, CT 06254-1807
Phone (860) 889-7345
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.95 of 100
- Quality
- 83.12
- Improvement activities
- 40
- Cost
- 84.36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130110000007 | CT | Practitioner - Physical Therapist in Private Practice | 1557514148 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8428 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norwich Orthopedic Group, P.C. | Current |
Accepting new patients | |
| Norwich Orthopedic Group, P.C. | Physical Therapist | Current |
Accepting new patients |
Locations
11 Industrial Park Rd
Niantic, CT 06357
Phone (860) 391-9397
82 New Park Ave
North Franklin, CT 06254
Phone (860) 889-7345
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
82 New Park Ave
North Franklin, CT 06254-1807
Mailing address
148 Woodbine Rd
Colchester, CT 06415-1884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT21572 | Other | FL | LICENSE # |
Other providers in North Franklin, CT
- Rebecca A. Sheehan
- Emilia Slabinski
- Aaron D Smith
- June Sohn
- Scott Stanat
- Patricia A Stuart
- Mary Thompson
- Abigail Elizabeth Thurlow
- Tamora Void
- Julie Wojnar
All providers in North Franklin, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.