Individual provider Active NPI

Joel Paul, MSPT

  • Physical Therapist
  • Woodbridge, CT
National Provider Identifier
1720163009
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7421 Issued in CT
Practice address
1 Bradley Rd
Suite #801
Woodbridge, CT 06525-2296
Phone
(203) 389-4593
Fax
(203) 389-4609
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7421 CT Primary

Addresses

Primary practice location

1 Bradley Rd
Suite #801
Woodbridge, CT 06525-2296

Mailing address

1 Bradley Rd
Suite #801
Woodbridge, CT 06525-2296
Phone (203) 389-4593

Other identifiers 3

IdentifierTypeStateIssuer
080007421CT07OtherCTANTHEM BC BS
080007421CT05OtherCTANTHEM BC BS
080007421CT06OtherCTANTHEM BC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040105000257 CT Practitioner - Physical Therapist in Private Practice 6305745829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amity Physical Therapy LLCGroup PAC ID 1850375338, 12 clinicians

Practice addresses (Care Compare)

1 Bradley Rd
Suite 801
Woodbridge, CT 06525-2296
Phone (202) 389-4593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7421CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Amity Physical Therapy LLC Physical Therapist CurrentSince Dec 1, 2008 Accepting new patients
Foot & Ankle Physical Therapy & Rehab Medicine Physical Therapist Past Accepting new patients
Active Orthopedic Therapy PC Physical Therapist Past Accepting new patients
Integrated Rehabilitation Services, LLC Physical Therapist PastSince Mar 18, 2019 Accepting new patients

Locations

103 N Main St
Branford, CT 06405
Phone (203) 315-7071

2320 Whitney Ave
Hamden, CT 06518
Phone (203) 691-6248

316 Main St
Wallingford, CT 06492
Phone (203) 626-5330

1 Bradley Rd
Ste 801
Woodbridge, CT 06525
Phone (202) 389-4593

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1720163009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE #801",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252296",
            "telephone_number": "203-389-4593",
            "fax_number": "203-389-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE #801",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252296",
            "telephone_number": "203-389-4593",
            "fax_number": "203-389-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "JOEL",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "7421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "080007421CT07",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "080007421CT05",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "080007421CT06",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.

Verify at the official NPI Registry.