Individual provider Active NPI

Colleen M Brauch, DPT

  • Physical Therapist
  • Salem, NH
National Provider Identifier
1568634277
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4435 Issued in NH
Practice address
16 Pelham Rd Ste 2
Salem, NH 03079-2826
Phone
(603) 894-1111
Fax
(603) 894-1113
NPI assigned
Apr 2, 2008
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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 4435 NH Primary

Addresses

Primary practice location

16 Pelham Rd Ste 2
Salem, NH 03079-2826

Mailing address

16 Pelham Rd Ste 2
Salem, NH 03079-2826
Phone (603) 894-1111

Other names 1

  • Ms. Colleen Muldoon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181130000230 NH Practitioner - Physical Therapist in Private Practice 4789727199 Reassigns benefits to 3 organizations
I20230116000247 MA Practitioner - Physical Therapist in Private Practice 4789727199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

68 Park St
Unit 6a
Andover, MA 01810-3693
Phone (978) 447-2221

68 Park St Unit
6A
Andover, MA 01810-3693

9 Edgewood Rd
Windham, NH 03087-2106
Phone (978) 447-2221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4435NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Physical Therapy Physical Therapist CurrentSince Oct 23, 2013 Accepting new patients
Visiting Therapists LLC CurrentSince Dec 31, 2023 Accepting new patients
Eone Medical Subsidiary PLLC CurrentSince Apr 16, 2022 Accepting new patients
Eone Medical PLLC CurrentSince Mar 24, 2022 Accepting new patients
Visiting Therapists LLC Physical Therapist CurrentSince Dec 31, 2023 Accepting new patients
Eone Medical PLLC CurrentSince Mar 24, 2022 Accepting new patients
Advanced Physical Therapy Solutions LLC Physical Therapist PastSince Jun 1, 2004 Accepting new patients
Eone Medical Subsidiary PLLC Past Accepting new patients
Optima Sports Therapy & Rehabilitation PastSince Oct 15, 2018 Accepting new patients

Locations

16 Pelham Rd
Salem, NH 03079
Phone (603) 894-1111

16 Pelham Rd
Ste 1
Salem, NH 03079
Phone (603) 898-2244

16 Pelham Rd
Ste 2
Salem, NH 03079
Phone (603) 894-1111

Organizations & group practices 9

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1568634277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PELHAM RD STE 2",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792826",
            "telephone_number": "603-894-1111",
            "fax_number": "603-894-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PELHAM RD STE 2",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792826",
            "telephone_number": "603-894-1111",
            "fax_number": "603-894-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUCH",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "4435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MULDOON",
            "prefix": "MS.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.