Individual provider Active NPI

Paula Pineda Nicolas, PT

  • Physical Therapist
  • Trumbull, CT
National Provider Identifier
1801940432
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008024 Issued in CT
Practice address
5520 Park Ave
Suite 208
Trumbull, CT 06611-3463
Phone
(203) 368-1192
Fax
(203) 371-0358
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 008024 CT Primary

Addresses

Primary practice location

5520 Park Ave
Suite 208
Trumbull, CT 06611-3463

Mailing address

5520 Park Ave
Suite 208
Trumbull, CT 06611-3463
Phone (203) 368-1192

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehab PT CT, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000177 CT Practitioner - Physical Therapist in Private Practice 2769572601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008024CTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT CT, LLC Physical Therapist CurrentSince Aug 15, 2024 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1801940432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "address_2": "SUITE 208",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-368-1192",
            "fax_number": "203-371-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PARK AVE",
            "address_2": "SUITE 208",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113463",
            "telephone_number": "203-368-1192",
            "fax_number": "203-371-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA NICOLAS",
        "first_name": "PAULA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab PT CT, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "655 Main St S",
            "city": "Southbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064884220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.