Individual provider Active NPI

Timothy Dontel Brown, PT

  • Physical Therapist
  • Norwich, CT
National Provider Identifier
1457029217
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14611 Issued in CT
Practice address
1 Towne Park PLZ
Norwich, CT 06360-2247
Phone
(860) 886-9111
NPI assigned
Sep 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 047405-01 NY
Physical Therapist 225100000X 14611 CT Primary

Addresses

Primary practice location

1 Towne Park PLZ
Norwich, CT 06360-2247

Mailing address

1 Towne Park PLZ
Norwich, CT 06360-2247
Phone (860) 886-9111

Other practice location 1

21273 26th Ave
Bayside, NY 11360-1943
Phone (718) 747-2019

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909001691 NY Practitioner - Physical Therapist in Private Practice 0840696274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047405-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Doctor,P.C Physical Therapist CurrentSince Sep 5, 2021 Accepting new patients

Locations

21273 26th Ave
Bayside, NY 11360
Phone (718) 747-2019

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

NPI Registry JSON

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1457029217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TOWNE PARK PLZ",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602247",
            "telephone_number": "860-886-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TOWNE PARK PLZ",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602247",
            "telephone_number": "860-886-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21273 26th Ave",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113601943",
            "country_code": "US",
            "telephone_number": "718-747-2019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIMOTHY",
        "middle_name": "DONTEL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-05",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047405-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.