Active NPI
Michelle M Maiorino, DPT
- Physical Therapist
- Colchester, CT
National Provider Identifier
1720055239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 008104
- Practice address
- 7 Park Ave
Colchester, CT 06415-1128 - Phone
- (860) 531-3222
- Fax
- (860) 531-3224
- NPI assigned
- Mar 2, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 008104 | CT | Primary |
Addresses
Primary practice location
7 Park Ave
Colchester, CT 06415-1128
Mailing address
7 Park Ave
Colchester, CT 06415-1128
Phone (860) 537-6798
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070808000061 | CT | Practitioner - Physical Therapist in Private Practice | 8628169463 |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7 Park Ave
Suite 4
Colchester, CT 06415-1128
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008104 | CT | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1720055239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 PARK AVE",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064151128",
"telephone_number": "860-537-6798",
"fax_number": "860-531-3224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 PARK AVE",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064151128",
"telephone_number": "860-531-3222",
"fax_number": "860-531-3224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIORINO",
"first_name": "MICHELLE",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-02",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "008104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.