Individual provider Active NPI

Laura Fetko, PT, DPT

  • Physical Therapist
  • Avon, CT
National Provider Identifier
1508533159
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13268 Issued in CT
Practice address
302 W Main St Ste 204
Avon, CT 06001-4306
Phone
(860) 679-0430
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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 13268 CT Primary

Addresses

Primary practice location

302 W Main St Ste 204
Avon, CT 06001-4306

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (630) 296-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221117002209 CT Practitioner - Physical Therapist in Private Practice 0840668174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magna Physical Therapy and Golf Medicine Center, LLCGroup PAC ID 6901983329, 6 clinicians

Practice addresses (Care Compare)

302 W Main St
Avon, CT 06001-4306
Phone (860) 679-0430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Magna Physical Therapy & Golf Medicine Center, LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

302 W Main St
Ste 204
Avon, CT 06001
Phone (860) 679-0430

61 Maple Ave
Ste 2
Collinsville, CT 06019
Phone (860) 352-2463

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1508533159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST STE 204",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014306",
            "telephone_number": "860-679-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETKO",
        "first_name": "LAURA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "13268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.