Active NPI
Mira Sheena Romero, PT
- Physical Therapist
- Middletown, CT
National Provider Identifier
1619459609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10053
- Practice address
- 100 Randolph Rd
Middletown, CT 06457-5637 - Phone
- (860) 344-0353
- NPI assigned
- Sep 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040303 | NY | |
| Physical Therapist | 225100000X | 10053 | CT | Primary |
Addresses
Primary practice location
100 Randolph Rd
Middletown, CT 06457-5637
Mailing address
124 Chestnut Dr
Colchester, CT 06415-1422
Phone (914) 539-0751
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 |
|---|---|---|---|
| 10053 | CT | MD | Social Worker |
| 040303 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536105600000",
"number": "1619459609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 CHESTNUT DR",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064151422",
"telephone_number": "914-539-0751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 RANDOLPH RD",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064575637",
"telephone_number": "860-344-0353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMERO",
"first_name": "MIRA SHEENA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-05",
"last_updated": "2018-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "040303",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "10053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.