Individual provider Active NPI

David Cegelka, PT

  • Physical Therapist
  • Waterbury, CT
National Provider Identifier
1598847170
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3406 Issued in CT
Practice address
47 Vernon St
Waterbury, CT 06708-3008
Phone
(203) 753-6043
Fax
(203) 574-3127
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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 3406 CT Primary

Addresses

Primary practice location

47 Vernon St
Waterbury, CT 06708-3008

Mailing address

27 Depot St
Watertown, CT 06795-2601
Phone (860) 274-4092

Other identifiers 2

IdentifierTypeStateIssuer
080003406CT05OtherCTANTHEM BBC BS
080003406CT03OtherCTANTHEM BC BS

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
3406CTMDOptometrist
003406CTMDChore Provider

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist PastSince Dec 15, 2004 Accepting new patients
Sacred Heart University, Inc Physical Therapist Past Accepting new patients
Norwich Orthopedic Group, P.C. Physical Therapist Past Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Mar 18, 2019 Accepting new patients

Organizations & group practices 4

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1598847170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DEPOT ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952601",
            "telephone_number": "860-274-4092",
            "fax_number": "860-274-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 VERNON ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083008",
            "telephone_number": "203-753-6043",
            "fax_number": "203-574-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEGELKA",
        "first_name": "DAVID",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "3406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BBC BS",
            "identifier": "080003406CT05",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "080003406CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.