Stacy Smith Wagner, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9052 Issued in CT

Practice address

1481 Chapel St
New Haven, CT 06511

Phone

(203) 776-9110

Fax

(203) 777-5879

NPI assigned

May 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ptsma, Inc.

  • Physical Therapy Clinic/Center
  • Pawcatuck, CT
  • NPI 1033773759

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Madison Rehabilitation Center Inc

  • Physical Therapy Clinic/Center
  • Madison, CT
  • NPI 1750350245

  Physical Therapist

  Medicare reassignment NPD
• Orthopaedic Surgeons PC

  • Specialist
  • New Haven, CT
  • NPI 1801002696
  Medicare reassignment NPD
• Ptsma Inc

  • Physical Therapy Clinic/Center
  • Manchester, CT
  • NPI 1619393337
  NPD
• Ptsma, Inc.

  • Physical Therapy Clinic/Center
  • New Haven, CT
  • NPI 1306472576
  NPD
• Anb-Ptsma Holdings, Inc.

  • Physical Therapist
  • West Hartford, CT
  • NPI 1659453371
  NPD (past)
• Integrated Rehabilitation Services, LLC

  • Physical Therapist
  • Vernon, CT
  • NPI 1104867951
  NPD (past)
• Norwich Orthopedic Group, P.C.

  • Orthopaedic Surgery Physician
  • North Franklin, CT
  • NPI 1558316919

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1801188750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114305",
            "telephone_number": "203-776-9110",
            "fax_number": "203-777-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-776-9110",
            "fax_number": "203-777-5879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "481 Gold Star Hwy",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "CT",
            "postal_code": "063406702",
            "country_code": "US",
            "telephone_number": "860-446-8254",
            "fax_number": "860-446-8293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STACY",
        "middle_name": "SMITH",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "9052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatma Fawzy Abdallahsemida Wafy, M.B.B.CH
• Denise Catherine Wagner, APRN
• Lauren Wagner, PHARMD
• Rita J Wagner
• Sheyla Wagner, DO
• Brenda Wagoner
• Wake Up, LLC
• Andrew Stewart Wakeman, MB BCH BAO
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Physical Therapist in New Haven, CT
• Providers in New Haven, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.