Individual provider Active NPI

Kerry D Rudich, PT

  • Physical Therapist
  • Shelton, CT
National Provider Identifier
1326010109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004470 Issued in CT
Practice address
2 Corporate Dr
Suite 233
Shelton, CT 06484-6238
Phone
(203) 924-5370
Fax
(203) 924-5372
NPI assigned
Feb 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 004470 CT Primary

Addresses

Primary practice location

2 Corporate Dr
Suite 233
Shelton, CT 06484-6238

Mailing address

148 East Ave
Suite 2M
Norwalk, CT 06851-5721
Phone (203) 866-5454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070227000167 CT Practitioner - Physical Therapist in Private Practice 2769584424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.92 of 100Reported as group
Quality
58.9
Promoting interoperability
82
Improvement activities
40
Cost
75.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004470CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Hospital Association CurrentSince Feb 1, 2007 Accepting new patients
Norwalk Hospital Association CurrentSince Feb 1, 2007 Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Sep 15, 2014 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist Past Accepting new patients

Locations

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

Organizations & group practices 5

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": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326010109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "address_2": "SUITE 2M",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721",
            "telephone_number": "203-866-5454",
            "fax_number": "203-354-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORPORATE DR",
            "address_2": "SUITE 233",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846238",
            "telephone_number": "203-924-5370",
            "fax_number": "203-924-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDICH",
        "first_name": "KERRY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "004470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.