Individual provider Active NPI

Jaden Rafael Calixto, DPT

  • Physical Therapist
  • Newington, CT
National Provider Identifier
1336027036
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15105 Issued in CT
Practice address
2434 Berlin Tpke Ste 14
Newington, CT 06111-4122
Phone
(860) 687-9700
Fax
(860) 422-4632
NPI assigned
Aug 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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 15105 CT Primary

Addresses

Primary practice location

2434 Berlin Tpke Ste 14
Newington, CT 06111-4122

Mailing address

188 England Rd
Chaplin, CT 06235-2408
Phone (860) 933-5625

Other practice location 1

176 Oakwood Dr
Glastonbury, CT 06033-2432
Phone (860) 687-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260217001730 CT Practitioner - Physical Therapist in Private Practice 1850871047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Roba Physical Therapy and Wellness LLCGroup PAC ID 4082003819, 6 clinicians

Practice addresses (Care Compare)

2434 Berlin Tpke
Suite 14
Newington, CT 06111-4122
Phone (860) 687-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15105CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roba Physical Therapy and Wellness LLC Physical Therapist CurrentSince Dec 8, 2025 Accepting new patients

Locations

176 Oakwood Dr
Glastonbury, CT 06033
Phone (860) 687-9700

2434 Berlin Tpke
Ste 14
Newington, CT 06111
Phone (860) 687-9700

37 Ann St
Newington, CT 06111
Phone (508) 963-3501

Organizations & group practices 1

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": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1336027036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 ENGLAND RD",
            "city": "CHAPLIN",
            "state": "CT",
            "postal_code": "062352408",
            "telephone_number": "860-933-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 BERLIN TPKE STE 14",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061114122",
            "telephone_number": "860-687-9700",
            "fax_number": "860-422-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Oakwood Dr",
            "address_purpose": "LOCATION",
            "city": "Glastonbury",
            "state": "CT",
            "postal_code": "060332432",
            "country_code": "US",
            "telephone_number": "860-687-9700",
            "fax_number": "860-422-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALIXTO",
        "first_name": "JADEN",
        "middle_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "15105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.