Individual provider Active NPI

Elise Marie Levesque, MPT

  • Physical Therapist
  • Torrington, CT
National Provider Identifier
1548434178
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008286 Issued in CT
Practice address
30 Peck Rd
Building #1; Suite 1101
Torrington, CT 06790-6123
Phone
(860) 489-0867
Fax
(860) 489-4473
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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 008286 CT Primary

Addresses

Primary practice location

30 Peck Rd
Building #1; Suite 1101
Torrington, CT 06790-6123

Mailing address

30 Peck Rd
BLDG #1; Suite 1101
Torrington, CT 06790-6123
Phone (860) 489-0867

Other names 1

  • Ms. Elise Marie Gelinas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080707000446 CT Practitioner - Physical Therapist in Private Practice 4587736665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maletta Pfeiffer and Associates, L.L.C.Group PAC ID 0446284178, 9 clinicians

Practice addresses (Care Compare)

30 Peck Rd
Suite 1101
Torrington, CT 06790-6123
Phone (860) 489-0867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008286CTMDOral and Maxillofacial Surgery (Dentist)

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": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1548434178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PECK RD",
            "address_2": "BLDG #1; SUITE 1101",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906123",
            "telephone_number": "860-489-0867",
            "fax_number": "860-489-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PECK RD",
            "address_2": "BUILDING #1; SUITE 1101",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906123",
            "telephone_number": "860-489-0867",
            "fax_number": "860-489-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "ELISE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "GELINAS",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.