Individual provider Active NPI

Martha Santandreu, DPT

  • Physical Therapist
  • Wallingford, CT
National Provider Identifier
1518330950
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010500 Issued in CT
Practice address
101 N Plains Industrial Rd
Wallingford, CT 06492-2360
Phone
(203) 265-0018
Fax
(203) 265-4368
NPI assigned
Nov 6, 2015
Last updated
Nov 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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 010500 CT Primary

Addresses

Primary practice location

101 N Plains Industrial Rd
Wallingford, CT 06492-2360

Mailing address

4175 Veterans Memorial Hwy
Ste 202
Ronkonkoma, NY 11779-7639
Phone (631) 580-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240820003989 AK Practitioner - Physical Therapist in Private Practice 0143520973 Reassigns benefits to 1 organization
I20251202003158 OR Practitioner - Physical Therapist in Private Practice 0143520973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corvallis Sport and Spine Physical Therapy IncGroup PAC ID 2961469333, 15 clinicians

Practice addresses (Care Compare)

2635 NW Rolling Green Dr
Corvallis, OR 97330-3519
Phone (541) 752-0545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010500CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nor-Alaska Physical Therapy, LLC Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients
Corvallis Sport and Spine Physical Therapy Inc Physical Therapist CurrentSince Oct 7, 2025 Accepting new patients
Corvallis Sport and Spine Physical Therapy Inc Physical Therapist PastSince Oct 7, 2025 Accepting new patients

Locations

11470 Business Blvd
Ste 200
Eagle River, AK 99577
Phone (907) 696-5678

613 Hickory St NW
Albany, OR 97321
Phone (541) 753-4246

2635 NW Rolling Green Dr
Corvallis, OR 97330
Phone (541) 752-0545

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1518330950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 VETERANS MEMORIAL HWY",
            "address_2": "STE 202",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797639",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N PLAINS INDUSTRIAL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922360",
            "telephone_number": "203-265-0018",
            "fax_number": "203-265-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTANDREU",
        "first_name": "MARTHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.