NPIMap

Organization Active NPI

Prestige Rehab CT PLLC

  • Physical Therapist
  • Hartford, CT
National Provider Identifier
1619783495
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PRESTIGE REHAB CT PLLC
Practice address
36 Russ St FL 3
Hartford, CT 06106-1520
Phone
(855) 678-8887
Fax
(855) 678-8887
NPI assigned
Dec 6, 2024
Last updated
Jan 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Daniel Reizis, PTNPI 1174835755
Title
Ceo
Phone
(908) 670-7573

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

36 Russ St FL 3
Hartford, CT 06106-1520

Mailing address

36 Russ St FL 3
Hartford, CT 06106-1520
Phone (855) 678-8887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250210002464 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7416487152 Receives reassigned benefits from 16 practitioners
Practice locations: Hartford, CT

National Provider Directory

National Provider Directory

Locations

36 Russ St
Fl 3
Hartford, CT 06106
Phone (301) 785-2099

211 Danbury Rd
Wilton, CT 06897
Phone (203) 423-7500

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1619783495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 RUSS ST FL 3",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061520",
            "telephone_number": "855-678-8887",
            "fax_number": "855-678-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 RUSS ST FL 3",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061061520",
            "telephone_number": "855-678-8887",
            "fax_number": "855-678-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE REHAB CT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "REIZIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-670-7573",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.