Victor Hernandez
Individual provider Active NPI Physical Therapist · Old Greenwich, CT
NPI 1508647694 · NPPES record last updated Nov 14, 2025
Key facts
- NPI
- 1508647694
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 051842 (CT)
- Practice address
- 1455 E Putnam Ave Ste 2
Old Greenwich, CT 06870-1360 - Phone
- (203) 817-0196
- NPI assigned
- Oct 13, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivyrehab Connecticut Inc
Practice addresses (Care Compare)
1455 E Putnam Ave
Suite 2
Old Greenwich, CT 06870-1360
Phone (203) 817-0196
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240209001201 | NY | Practitioner - Physical Therapist in Private Practice | 1052754736 | Reassigns benefits to 1 organization |
| I20251208002466 | CT | Practitioner - Physical Therapist in Private Practice | 1052754736 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051842 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Connecticut, Inc. | Physical Therapist | Current |
Accepting new patients |
| Edra Stern MD LLC | Current |
Accepting new patients | |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC | Current |
Accepting new patients | |
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path | Physical Therapist | Current |
Accepting new patients |
Locations
1455 E Putnam Ave
Ste 2
Old Greenwich, CT 06870
Phone (203) 661-4242
101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018
550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737
672 White Plains Rd
Scarsdale, NY 10583
Phone (914) 722-2400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 051842 | CT | Yes |
Addresses
Primary practice location
1455 E Putnam Ave Ste 2
Old Greenwich, CT 06870-1360
Mailing address
392 Irving Ave
Port Chester, NY 10573-3052
Phone (914) 565-5348
Other providers in Old Greenwich, CT
- Daniel Caleb Guarini
- Cristina Guzman
- Jamie Halcom
- Mary Louanna Heaven
- Jaydel Hernandez
- Tania Lee Hill
- Lindsay Madison Hodges
- Sarah Hoyt
- Elizabeth Andrews Hutchins
- Juliana Ippolito
All providers in Old Greenwich, 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 Nov 14, 2025. 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.