Individual provider Active NPI

Denise Pantason, PTA

  • Physical Therapy Assistant
  • Tolland, CT
National Provider Identifier
1346514445
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
001121 Issued in CT
Practice address
9B Fieldstone CMNS
Tolland, CT 06084-3421
Phone
(860) 870-9800
Fax
(860) 870-9804
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 001121 CT Primary

Addresses

Primary practice location

9B Fieldstone CMNS
Tolland, CT 06084-3421

Mailing address

12 Main St
Suite 2
Ellington, CT 06029-3339
Phone (860) 979-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001121CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services Limited Partnership PastSince Dec 1, 2022 Accepting new patients
Integrated Rehabilitation Services, LLC PastSince Apr 21, 2003 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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1346514445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MAIN ST",
            "address_2": "SUITE 2",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293339",
            "telephone_number": "860-979-1600",
            "fax_number": "203-866-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9B FIELDSTONE CMNS",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843421",
            "telephone_number": "860-870-9800",
            "fax_number": "860-870-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTASON",
        "first_name": "DENISE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "001121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolland, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.