Individual provider Active NPI

Karen Bidwell, PT

  • Physical Therapist
  • Glastonbury, CT
National Provider Identifier
1437255304
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006678 Issued in CT
Practice address
84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468
Phone
(860) 633-6292
Fax
(860) 633-6299
NPI assigned
Sep 16, 2006
Last updated
Nov 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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 006678 CT Primary

Addresses

Primary practice location

84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468

Mailing address

84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468
Phone (860) 633-6292

Other identifiers 1

IdentifierTypeStateIssuer
004213063MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816000104 CT Practitioner - Physical Therapist in Private Practice 8022302959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Sports Specialists PCGroup PAC ID 0840254678, 9 clinicians

Practice addresses (Care Compare)

84 Glastonbury Blvd
Suite 101
Glastonbury, CT 06033-4468
Phone (860) 652-8883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006678CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Sports Specialists, PC CurrentSince Sep 1, 2016 Accepting new patients
Orthopaedic Sports Specialists, PC PastSince Sep 1, 2016 Accepting new patients
SFH-FF,LLC Physical Therapist Past Accepting new patients

Locations

84 Glastonbury Blvd
Ste 101
Glastonbury, CT 06033
Phone (860) 633-6292

84 Glastonbury Blvd
Ste 103
Glastonbury, CT 06033
Phone (860) 633-6292

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1437255304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 GLASTONBURY BLVD",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334468",
            "telephone_number": "860-633-6292",
            "fax_number": "860-633-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 GLASTONBURY BLVD",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334468",
            "telephone_number": "860-633-6292",
            "fax_number": "860-633-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDWELL",
        "first_name": "KAREN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004213063",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.