Kevin T Tucker, DPT

Key facts

NPI

1386259307

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

12759 (CT)

Practice address

881 New Harwinton Rd
Torrington, CT 06790-5948

Phone

(860) 482-0600

Fax

(860) 482-0601

NPI assigned

Sep 15, 2020

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Advanced Physical Therapy, LLC Physical Therapist · Wolcott, CT · NPI 1861677262
  Medicare reassignment Care Compare group NPD CT · PHYSICAL THERAPIST
• Professional Occupational & Physical Therapy, PLLC Occupational Therapist · Darien, CT · NPI 1629528120
  Medicare reassignment CT
• Professional Occupational & Physical Therapy, PLLC Occupational Therapist · Southport, CT · NPI 1073063574
  NPD PHYSICAL THERAPIST
• Professional Occupational & Physical Therapy, PLLC Occupational Therapist · Randolph, NJ · NPI 1104376680
  NPD PHYSICAL THERAPIST
• Community Physical Therapy Physical Therapist · Wolcott, CT · NPI 1528275872
  NPD (past) PHYSICAL THERAPIST

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLC (497 clinicians)
Advanced Physical Therapy, LLC (23 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CT

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 15, 2020.

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1386259307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WOLCOTT RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162613",
            "telephone_number": "203-879-0107",
            "fax_number": "203-879-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 NEW HARWINTON RD",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067905948",
            "telephone_number": "860-482-0600",
            "fax_number": "860-482-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Torrington, CT · Physical Therapist in Connecticut