Individual provider Active NPI

Ryan Vannieuwenhuyze, DPT

  • Physical Therapist
  • North Haven, CT
National Provider Identifier
1760840839
Registry record updated Jul 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010804 Issued in CT
Practice address
87 Washington Ave
North Haven, CT 06473-1705
Phone
(203) 679-1476
NPI assigned
Feb 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2021

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 010804 CT Primary

Addresses

Primary practice location

87 Washington Ave
North Haven, CT 06473-1705

Mailing address

10 Avalon Dr Unit 3232
Milford, CT 06460-8576
Phone (203) 679-1476

Other practice location 1

586 Middle Tpke E
Manchester, CT 06040-3730
Phone (860) 645-3810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010804CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbell Physical Therapy and Performance, LLC CurrentSince Jul 17, 2021 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist CurrentSince Jul 10, 2023 Accepting new patients

Locations

586 Middle Tpke E
Manchester, CT 06040
Phone (860) 645-3810

87 Washington Ave
North Haven, CT 06473
Phone (203) 679-1476

230 Mountain Rd
Fl 2
Suffield, CT 06078
Phone (860) 668-9589

435 Hartford Tpke
Ste U
Vernon Rockville, CT 06066
Phone (860) 870-8272

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1760840839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AVALON DR UNIT 3232",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064608576",
            "telephone_number": "203-679-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731705",
            "telephone_number": "203-679-1476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "586 Middle Tpke E",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060403730",
            "country_code": "US",
            "telephone_number": "860-645-3810",
            "fax_number": "860-645-3814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANNIEUWENHUYZE",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-04",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "010804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.