Individual provider Active NPI

Olga Kolenberg, PT

  • Physical Therapy Clinic/Center
  • Cos Cob, CT
National Provider Identifier
1588329569
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
006882 Issued in CT
Practice address
132 E Putnam Ave Ste 14
Cos Cob, CT 06807-2753
Phone
(203) 512-4149
Fax
(203) 358-0052
NPI assigned
Nov 3, 2021
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 006882 CT Primary
Pediatric Rehabilitation Medicine Physician 2081P0010X 006882 CT
Pediatric Physical Therapist 2251P0200X 006882 CT

Addresses

Primary practice location

132 E Putnam Ave Ste 14
Cos Cob, CT 06807-2753

Mailing address

11 Bertmor Dr
Stamford, CT 06905-2114
Phone (203) 512-4149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006882CTMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Caitlin M. Ingraham, M.S., CCC-SLP CurrentSince Dec 15, 2024 Accepting new patients

Locations

132 E Putnam Ave
Ste 14
Cos Cob, CT 06807
Phone (203) 512-4149

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, 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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1588329569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BERTMOR DR",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069052114",
            "telephone_number": "203-512-4149",
            "fax_number": "203-990-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E PUTNAM AVE STE 14",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072753",
            "telephone_number": "203-512-4149",
            "fax_number": "203-358-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLENBERG",
        "first_name": "OLGA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "006882",
            "primary": true
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "CT",
            "license": "006882",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CT",
            "license": "006882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.