Individual provider Active NPI

Jillian Grey, PT, DPT

  • Physical Therapist
  • Waterford, CT
National Provider Identifier
1477986396
Registry record updated Nov 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9898 Issued in CT
Practice address
86 Boston Post Rd
Suite 1
Waterford, CT 06385-2434
Phone
(860) 444-8713
Fax
(860) 444-1671
NPI assigned
Aug 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 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 9898 CT Primary

Addresses

Primary practice location

86 Boston Post Rd
Suite 1
Waterford, CT 06385-2434

Mailing address

86 Boston Post Rd
Suite 1
Waterford, CT 06385-2434
Phone (860) 444-8713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150824000033 CT Practitioner - Physical Therapist in Private Practice 9931414786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Phoenix Ave
2D
Enfield, CT 06082-4470
Phone (860) 741-2541

Merit-based Incentive Payment System (MIPS)

Final score
86.66 of 100Reported as group
Quality
87.71
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grey Physical Therapy & Sports Medicine Center of Enfield, PC Physical Therapist CurrentSince Jul 30, 2015 Accepting new patients

Locations

101 Phoenix Ave
Ste 2D
Enfield, CT 06082
Phone (860) 741-2541

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.

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385683200000",
    "number": "1477986396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 BOSTON POST RD",
            "address_2": "SUITE 1",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852434",
            "telephone_number": "860-444-8713",
            "fax_number": "860-444-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 BOSTON POST RD",
            "address_2": "SUITE 1",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063852434",
            "telephone_number": "860-444-8713",
            "fax_number": "860-444-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "JILLIAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "9898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.