Primary Physical Medicine LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

006454 Issued in CT

Legal business name

PRIMARY PHYSICAL MEDICINE LLC

Practice address

143 Hazard Ave
Enfield, CT 06082-4521

Phone

(860) 763-2225

NPI assigned

Jan 6, 2017

Last updated

Jan 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin E Sadowski, APRN DCNPI 1205885340

Title

Sole Owner

Phone

(860) 763-2225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin E Sadowski, MSN, FNP-C

  • Nurse Practitioner
  • Enfield, CT
  • NPI 1205885340
  Medicare reassignment NPD Authorized official
• Zoryana Bilohan, APRN

  • Nurse Practitioner
  • Hartford, CT
  • NPI 1154044535
  Medicare reassignment NPD
• Beth A Finn, APRN, FNP

  • Family Nurse Practitioner
  • Bristol, CT
  • NPI 1912463662
  Medicare reassignment NPD
• Paul Pezzino, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Hartford, CT
  • NPI 1962647743
  Medicare reassignment NPD
• Karla Tatiana Guishard Fuentes, DPT

  • Physical Therapist
  • Waterbury, CT
  • NPI 1952110587
  NPD (past)

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1487190013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-763-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-763-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "SADOWSKI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "860-763-2225",
        "authorized_official_credential": "APRN DC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "006454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Portal
• Francesca Nicole Porter, LADC I
• Lynne Porter
• Rich P Prenetta
• Jillian Kay Prescod, PHARM.D.
• Primary Spine & Rehab LLC
• Renee Prince, MD
• Meghan Provost
• Alexandra Psilos
• Ptsma, Inc. (Select Physical Therapy)

• Family Nurse Practitioner in Enfield, CT
• Providers in Enfield, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.