Active NPI
Jonathan Weber
- Physical Therapist
- Suffield, CT
National Provider Identifier
1750255345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15076
- Practice address
- 152 Mountain Rd
Suffield, CT 06078-2058 - Phone
- (413) 789-0752
- NPI assigned
- Oct 6, 2025
- Last updated
- Oct 6, 2025
- Sex
- Male
- 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 | 15076 | CT | Primary |
Addresses
Primary practice location
152 Mountain Rd
Suffield, CT 06078-2058
Mailing address
38 Mohawk Dr
Averill Park, NY 12018-6014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10 Brandywine Dr
Mastic, NY 11950-1404
470 Shoemaker LN
Agawam, MA 01001-3620
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15076 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Resilience Physical Therapy and Wellness, LLC | Physical Therapist | Current | Accepting new patients |
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients |
Locations
152 Mountain Rd
Suffield, CT 06078
Phone (413) 789-0752
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1750255345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 MOHAWK DR",
"city": "AVERILL PARK",
"state": "NY",
"postal_code": "120186014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 MOUNTAIN RD",
"city": "SUFFIELD",
"state": "CT",
"postal_code": "060782058",
"telephone_number": "413-789-0752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-06",
"last_updated": "2025-10-06",
"certification_date": "2025-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "15076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.