Active NPI
Elita Alfonso, LMT
- Massage Therapist
- Glastonbury, CT
National Provider Identifier
1609489855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 8062
- Practice address
- 730 Hebron Ave
Glastonbury, CT 06033-5016 - Phone
- (860) 410-4490
- Fax
- (860) 410-4492
- NPI assigned
- Aug 27, 2020
- Last updated
- Aug 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 8062 | CT | Primary |
Addresses
Primary practice location
730 Hebron Ave
Glastonbury, CT 06033-5016
Mailing address
730 Hebron Ave
Glastonbury, CT 06033-5016
Phone (860) 410-4490
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lin@dccglastonbury.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8062 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Immerse LLC | Single Specialty | Current | Accepting new patients |
Locations
730 Hebron Ave
Glastonbury, CT 06033
Phone (860) 410-4490
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": "1598486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1609489855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 HEBRON AVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060335016",
"telephone_number": "860-410-4490",
"fax_number": "860-410-4492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 HEBRON AVE",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060335016",
"telephone_number": "860-410-4490",
"fax_number": "860-410-4492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALFONSO",
"first_name": "ELITA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-27",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "8062",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lin@dccglastonbury.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "730 Hebron Ave",
"city": "Glastonbury",
"state": "CT",
"country_code": "US",
"postal_code": "060335016",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.