Cory Patterson
Individual provider Active NPI Physical Therapist · East Granby, CT
NPI 1487764031 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487764031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 13 Church St
East Granby, CT 06026-9406 - Phone
- (860) 653-7341
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ptsma Inc
Practice addresses (Care Compare)
131 Kent Rd
New Milford, CT 06776-3485
Phone (860) 350-3330
1933 E Main St
Torrington, CT 06790-3102
Phone (959) 901-0640
2 Ivy Brook Rd
Suite 230
Shelton, CT 06484-6416
Phone (203) 373-0551
37 S Broad St
Unit 12
Pawcatuck, CT 06379-7909
Phone (860) 495-1919
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210202001172 | CT | Practitioner - Physical Therapist in Private Practice | 4981863917 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7646 | CT | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ptsma, Inc. | Physical Therapist | Current | Accepting new patients |
| Ptsma Inc | Current |
Accepting new patients | |
| Ptsma, Inc. | Current |
Accepting new patients |
Locations
13 Church Rd
East Granby, CT 06026
Phone (860) 653-4526
37 S Broad St
Ste 12
Pawcatuck, CT 06379
Phone (860) 495-1919
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
13 Church St
East Granby, CT 06026-9406
Mailing address
104 Stonehouse Way
Torrington, CT 06790-3561
Phone (860) 236-0748
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007646 | Other | CT | LICENSE # |
Other providers in East Granby, CT
- Ellen Ann Maurus
- Madeline Mondo
- Brent J Munson
- Petra Irmgard Mursch
- Rosa Noda-Clark
- Peaceful Minds Counseling, LLC
- Kelly Michelle Penn
- Cristine B. Piane
- Alicia Pitocco
- Krista Pochron
All providers in East Granby, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.