Cameron Elisha Tabacsko, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14133 Issued in CT

Practice address

84 Glastonbury Blvd Ste 101
Glastonbury, CT 06033-4468

Phone

(860) 652-8883

NPI assigned

Aug 25, 2023

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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, NH2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodywise Physical Therapy LLCGroup PAC ID 1456453794, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodywise Physical Therapy LLC

  • Physical Therapist
  • Epping, NH
  • NPI 1972682375
  Medicare reassignment Care Compare group NPD
• Orthopaedic Sports Specialists, PC

  • Orthopaedic Surgery Physician
  • Glastonbury, CT
  • NPI 1851310031
  Medicare reassignment NPD
• Orthopaedic Sports Specialists, PC

  • Durable Medical Equipment & Medical Supplies
  • Glastonbury, CT
  • NPI 1063531796
  NPD (past)

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1427833888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 POMEROY AVE APT 2301",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064501770",
            "telephone_number": "878-379-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 GLASTONBURY BLVD STE 101",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334468",
            "telephone_number": "860-652-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACSKO",
        "first_name": "CAMERON",
        "middle_name": "ELISHA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Switzer, LPC
• Naimet A. Syed, M.D.
• Synergy Psychology Group, LLC
• Athanasia D Syrengelas, MD PHD
• Andrea C Szerejko, MA, CCC-SLP
• Suzanne Tamer, RPH
• Joanne Tan, LCSW, LICSW
• Rajnish Tandon, M.D.
• Zhihui Tang, D.D.S.
• Christopher A Tanner, PHARMD RPH

• Physical Therapist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.