Individual provider Active NPI

David J Bostic, P.T.

  • Physical Therapist
  • Windsor, CT
National Provider Identifier
1386760429
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003110 Issued in CT
Practice address
1080 Day Hill Rd
Suite 201
Windsor, CT 06095-1781
Phone
(860) 944-8618
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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 003110 CT Primary

Addresses

Primary practice location

1080 Day Hill Rd
Suite 201
Windsor, CT 06095-1781

Mailing address

720 Cool Springs Blvd
Suite 300
Franklin, TN 37067-2626
Phone (615) 778-4066

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000559 CT Practitioner - Physical Therapist in Private Practice 9739357195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Connecticut School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Physical Therapy Specialists LLCGroup PAC ID 9638330236, 11 clinicians

Practice addresses (Care Compare)

11 Mill Pond Dr
Granby, CT 06035-2628
Phone (860) 413-9969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003110CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Physical Therapy Specialists LLC Physical Therapist CurrentSince Mar 1, 2012 Accepting new patients

Locations

60 Village Pl
Glastonbury, CT 06033
Phone (860) 999-1859

11 Mill Pond Dr
Granby, CT 06035
Phone (860) 413-9969

342 N Main St
Ste 150
West Hartford, CT 06117
Phone (860) 325-7481

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1386760429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COOL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672626",
            "telephone_number": "615-778-4066",
            "fax_number": "615-778-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 DAY HILL RD",
            "address_2": "SUITE 201",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951781",
            "telephone_number": "860-944-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "003110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.