Ethan Samuel Pollack, DPT, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14.015071 Issued in CT

Practice address

6540 Main St Ste 5
Trumbull, CT 06611-1364

Phone

(203) 816-0100

NPI assigned

Aug 9, 2025

Sex

Male

Sole proprietor

No

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

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elevate Holding Company, LLCGroup PAC ID 3678836061, 27 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 and National Provider Directory roles.

• Elevate Holding Company, LLC

  • Specialist
  • Yorktown Heights, NY
  • NPI 1851804488

  CT, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1754697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1477438240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CAMORE ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 MAIN ST STE 5",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111364",
            "telephone_number": "203-816-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK",
        "first_name": "ETHAN",
        "middle_name": "SAMUEL",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-09",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14.015071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol J Pisani, APRN
• Azaila Z Pitts
• Pivot and Peaks Occupational Therapy LLC
• Plastic and Reconstructive Surgery Specialists LLC
• Sandra Platt, LCSW
• Michael Patrick Pollock, M.D.
• Mary Anne Popovich
• Catherine Lawlor Pospisil, D.O.
• Alexis Victoria Possidento
• Camilla Powierza

• Physical Therapist in Trumbull, CT
• Providers in Trumbull, 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 9, 2025; 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.