MD Physical Therapy Associates

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

9446592000 Issued in CT

Legal business name

MD PHYSICAL THERAPY ASSOCIATES

Practice address

689 Campbell Ave
West Haven, CT 06516-3711

Phone

(203) 932-6481

Fax

(203) 932-4051

NPI assigned

Dec 15, 2009

Organization subpart

Yes

Parent organization

WEST HAVEN MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Anuruddha Walaliyadda, M.D.

Title

Managing Partner

Phone

(203) 932-6481

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

West Haven Medical Group LLC2 organizations share this tax ID, including this one

Part of

West Haven Medical Group LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• West Haven Medical Group, LLC

  • Nurse Practitioner
  • West Haven, CT
  • NPI 1669623484
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• West Haven Medical Group, LLC

  • Internal Medicine Physician
  • West Haven, CT
  • NPI 1417955923
  NPPES parent name

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1538498902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163711",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163711",
            "telephone_number": "203-932-6481",
            "fax_number": "203-932-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD PHYSICAL THERAPY ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST HAVEN MEDICAL GROUP, LLC",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "WALALIYADDA",
        "authorized_official_first_name": "ANURUDDHA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "203-932-6481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "9446592000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST HAVEN MEDICAL GROUP, LLC, NPI #",
            "identifier": "1417955923",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle McMullin, ODS-C
• Cynthia McNamara, MD
• David Joseph McNamara, R.N.
• Olivia Chase McNamer, PT, DPT
• Adam Noel McReynolds
• Judith L Meadows, MD
• Medical Center Pharmacy and Home Care Center, Inc.
• Wajahat Zafar Mehal, MD
• Emily Ann Melin, APRN, FNP-C
• Winsome Patricia Mellers, LCSW. CAC-CDAC

• Physical Medicine & Rehabilitation Physician in West Haven, CT
• Providers in West Haven, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.