Michael M Demetriades, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

008732 Issued in CT

Practice address

1 Bradley Rd
Suite 801
Woodbridge, CT 06525-2296

Phone

(203) 389-4593

Fax

(203) 389-4609

NPI assigned

Feb 5, 2010

Sex

Male

Sole proprietor

No

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.

• Amity Physical Therapy LLC

  • Physical Therapist
  • Woodbridge, CT
  • NPI 1528191426

  CT, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Foot & Ankle Physical Therapy & Rehab Medicine

  • Physical Therapist
  • Milford, CT
  • NPI 1164591459
  NPD (past)

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amity Physical Therapy LLC 12 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in CT

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2012.

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1811229586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 801",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252296",
            "telephone_number": "203-389-4593",
            "fax_number": "203-389-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD",
            "address_2": "SUITE 801",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252296",
            "telephone_number": "203-389-4593",
            "fax_number": "203-389-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIADES",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-05",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Davis, CPNP
• Dayspring Therapeutic Group LLC
• Sharon Dru De Kadt, NATUROPATHIC PHYSICI
• Leanne Anissa Delgado, LPC
• John Delizio, PH.D.
• Nicole Marie Derobertis, LCSW
• Nicholas Despoelberch, LPC
• Daron Dey
• Ava L Diamond, LCSW
• Dianon Systems Inc

• All providers in Woodbridge, CT
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.