NPIMap

Organization Active NPI

Baker Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Cos Cob, CT
National Provider Identifier
1730770934
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BAKER PHYSICAL THERAPY, LLC
Practice address
76 Valley Rd
Cos Cob, CT 06807-2533
Phone
(917) 744-6457
NPI assigned
Jan 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Dr. Tiffany Sudol Baker, PT, DPTNPI 1497145536
Title
Physical Therapist/Owner
Phone
(917) 744-6457

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251N0400X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

76 Valley Rd
Cos Cob, CT 06807-2533

Mailing address

120 Cherry LN
Wilton, CT 06897-3522
Phone (917) 744-6457

Other names 1

  • Baker Physical Therapy, LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220207001338 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9830582287 Receives reassigned benefits from 1 practitioner
Practice locations: Cos Cob, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1730770934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHERRY LN",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973522",
            "telephone_number": "917-744-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VALLEY RD",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072533",
            "telephone_number": "917-744-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKER PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-30",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "SUDOL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "917-744-6457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baker Physical Therapy, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.