Individual provider Active NPI

Anne Katarina Konstantino, PT

  • Physical Therapist
  • Old Saybrook, CT
National Provider Identifier
1477952455
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004764 Issued in CT
Practice address
210 Main St
Old Saybrook, CT 06475-2333
Phone
(860) 395-5300
Fax
(860) 395-5700
NPI assigned
Aug 15, 2014
Last updated
Aug 15, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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 004764 CT Primary

Addresses

Primary practice location

210 Main St
Old Saybrook, CT 06475-2333

Mailing address

4 Piney BR
Ivoryton, CT 06442-1243
Phone (860) 816-9355

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
004764CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rpat, Inc Past Accepting new patients

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, 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": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1477952455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PINEY BR",
            "city": "IVORYTON",
            "state": "CT",
            "postal_code": "064421243",
            "telephone_number": "860-816-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752333",
            "telephone_number": "860-395-5300",
            "fax_number": "860-395-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONSTANTINO",
        "first_name": "ANNE",
        "middle_name": "KATARINA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "004764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.