Individual provider Active NPI

Alex Gauthier, DPT

  • Physical Therapist
  • Essex, CT
National Provider Identifier
1790459352
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13218 Issued in CT
Practice address
12 Bokum Rd
Essex, CT 06426-1500
Phone
(860) 767-9035
NPI assigned
Aug 5, 2021
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 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 13218 CT Primary

Addresses

Primary practice location

12 Bokum Rd
Essex, CT 06426-1500

Mailing address

47 N Main St
West Hartford, CT 06107-1926
Phone (860) 409-4595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210823002246 CT Practitioner - Physical Therapist in Private Practice 0941605398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14 Jones Hollow Rd
Suite 5
Marlborough, CT 06447-1448
Phone (860) 347-7636

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
82.55
Promoting interoperability
100
Improvement activities
40
Cost
64.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13218CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic & Neurosurgery Specialists, PLLC Physical Therapist CurrentSince Sep 23, 2024 Accepting new patients
Orthopaedic & Neurosurgery Specialists, PLLC CurrentSince Sep 23, 2024 Accepting new patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Aug 5, 2021 Accepting new patients

Locations

12 Bokum Rd
Essex, CT 06426
Phone (860) 767-9035

6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145

14 Jones Hollow Rd
Ste 5
Marlborough, CT 06447
Phone (860) 295-8751

430 Saybrook Rd
Middletown, CT 06457
Phone (860) 638-3820

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

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, 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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1790459352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926",
            "telephone_number": "860-409-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BOKUM RD",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "064261500",
            "telephone_number": "860-767-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "ALEX",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "13218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.