Individual provider Active NPI

Daniel Tannenbaum, PT

  • Physical Therapist
  • Farmington, CT
National Provider Identifier
1730486671
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10861 Issued in CT
Practice address
499 Farmington Ave Ste 300
Farmington, CT 06032-1933
Phone
(860) 549-8986
Fax
(860) 284-9630
NPI assigned
Feb 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01386100 NJ
Physical Therapist 225100000X 10373 TN
Physical Therapist 225100000X 10861 CT Primary

Addresses

Primary practice location

499 Farmington Ave Ste 300
Farmington, CT 06032-1933

Mailing address

499 Farmington Ave Ste 300
Farmington, CT 06032-1933
Phone (860) 549-8986

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160602001323 CT Practitioner - Physical Therapist in Private Practice 9537342464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

499 Farmington Ave
Suite 300
Farmington, CT 06032-1933
Phone (860) 549-3210

Merit-based Incentive Payment System (MIPS)

Final score
94.04 of 100Reported as group
Quality
98.06
Promoting interoperability
100
Improvement activities
40
Cost
82.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10861CTMDSocial Worker
10373TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Hartford,PC CurrentSince Sep 11, 2018 Accepting new patients
Orthopedic Associates of Hartford,PC CurrentSince Sep 11, 2018 Accepting new patients
Connecticut Family Physical Therapy LLC CurrentSince Dec 20, 2016 Accepting new patients

Locations

499 Farmington Ave
Ste 300
Farmington, CT 06032
Phone (860) 549-8986

499 Farmington Ave
Fl 3
Farmington, CT 06032
Phone (860) 549-8986

31 Seymour St
Ste 100
Hartford, CT 06106
Phone (860) 549-8208

735 Post Rd E
Westport, CT 06880
Phone (203) 227-5431

Organizations & group practices 3

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": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1730486671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 FARMINGTON AVE STE 300",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321933",
            "telephone_number": "860-549-8986",
            "fax_number": "860-284-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 FARMINGTON AVE STE 300",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321933",
            "telephone_number": "860-549-8986",
            "fax_number": "860-284-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-11",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01386100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10373",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "10861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.