Active NPI
Prestige Rehab CT PLLC
- Physical Therapist
- Hartford, CT
National Provider Identifier
1619783495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Reizis, PT
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
36 Russ St
Fl 3
Hartford, CT 06106
Phone (301) 785-2099
Practitioners 17
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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.