Ellsworth Medical, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ELLSWORTH MEDICAL, LLC

Practice address

15 S Main St Ste B
East Granby, CT 06026-9550

Phone

(860) 431-4048

Fax

(860) 431-4058

NPI assigned

Aug 9, 2006

Last updated

Jul 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Allan Cosker Jr.

Title

Owner

Phone

(860) 431-4048

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1730199852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST STE B",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269550",
            "telephone_number": "860-431-4048",
            "fax_number": "860-431-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST STE B",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269550",
            "telephone_number": "860-431-4048",
            "fax_number": "860-431-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "COSKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-431-4048",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004122149",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "12DME0619CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devon Dusseault, PT, DPT
• East Granby Ambulance Assn
• East Granby Board of Education
• East Granby Family Practice LLC
• Educational Advancement Associates
• Maureen Elizabeth Emery, LCSW
• Edward M Ewald, MD
• Ellen Farmer Lanctot, DC
• Kristen Formanek, LCSW
• Fortify Wellness and Physical Therapy LLC

• Durable Medical Equipment & Medical Supplies in East Granby, CT
• Providers in East Granby, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.