Individual provider Active NPI

Michael J. Racca, PT, MSPT, CEAS

  • Physical Therapist
  • Westport, CT
National Provider Identifier
1477514404
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007475 Issued in CT
Practice address
735 Post Rd E
Westport, CT 06880-5238
Phone
(203) 227-5431
Fax
(877) 838-9260
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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 022380-1 NY
Physical Therapist 225100000X 007475 CT Primary

Addresses

Primary practice location

735 Post Rd E
Westport, CT 06880-5238

Mailing address

735 Post Rd E
Westport, CT 06880-5238
Phone (203) 227-5431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007475CTMDPhysical Therapist
022380-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlson Therapy Network, PC Physical Therapist CurrentSince Apr 17, 2023 Accepting new patients
Connecticut Family Physical Therapy LLC CurrentSince Jun 29, 2020 Accepting new patients
Nyconn Orthopaedic & Rehabalitation Specialists, PLLC Past Accepting new patients

Locations

816 Broad St
Meriden, CT 06450
Phone (203) 238-1334

6 Shaws Cv
Ste 101
New London, CT 06320
Phone (860) 444-9022

116 Danbury Rd
New Milford, CT 06776
Phone (203) 794-6331

116 Danbury Rd
Ste 5
New Milford, CT 06776
Phone (860) 354-7605

735 Post Rd E
Westport, CT 06880
Phone (203) 227-5431

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1477514404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805238",
            "telephone_number": "203-227-5431",
            "fax_number": "877-838-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805238",
            "telephone_number": "203-227-5431",
            "fax_number": "877-838-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACCA",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "PT, MSPT, CEAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022380-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "007475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.