Nicholas A Pisanelli, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12499 Issued in CT

Practice address

893 Main St Ste 302
East Hartford, CT 06108-2293

Phone

(860) 289-6021

NPI assigned

Nov 4, 2019

Last updated

Nov 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carlson Therapy Network PCGroup PAC ID 8527968445, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Carlson Therapy Network, PC

  dba Carlson Procare

  • Physical Therapist
  • New Milford, CT
  • NPI 1114979226
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1326682246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 MAIN ST STE 302",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082293",
            "telephone_number": "860-289-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 MAIN ST STE 302",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082293",
            "telephone_number": "860-289-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANELLI",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Professional Services
• Phoenix Psychiatry LLC
• Rebecca Blake Pieper, APRN FNP-BC
• Colae Pinnock
• Jayann L Pinto-Samuda, LCSW
• Gerald G Piserchia, M.D.
• Cheyenne Pitcher, BCBA, LBA
• Renay Denise Plummer
• Deborah Poerio, DNP, APRN, FNP-BC
• Allison Polesel, LCSW

• Physical Therapist in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.