Michelle B Broggi, RPT, PH. D.

Key facts

NPI

1679898522

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

3893 (CT)

Practice address

335 Highland Ave
Suite 201
Cheshire, CT 06410-2549

Phone

(203) 699-9264

Fax

(203) 271-1241

NPI assigned

Apr 5, 2010

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Ushus Therapy Services LLC Neurology Physical Therapist · Cheshire, CT · NPI 1801935937
  NPD (past) PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Philosophy

Practice roles

Specialties & licenses

Addresses

Other names

• Michelle Brodersen Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 5, 2010.

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1679898522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102549",
            "telephone_number": "203-699-9264",
            "fax_number": "203-271-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 HIGHLAND AVE",
            "address_2": "SUITE 201",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102549",
            "telephone_number": "203-699-9264",
            "fax_number": "203-271-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGGI",
        "first_name": "MICHELLE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "RPT, PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "3893",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CT",
            "license": "3893",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CT",
            "license": "3893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BRODERSEN",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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