Individual provider Active NPI

Shana Virtudes

  • Physical Therapist
  • Newington, CT
National Provider Identifier
1811714801
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14598 Issued in CT
Practice address
64 Market SQ
Newington, CT 06111-2911
Phone
(860) 881-2928
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 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 14598 CT Primary

Addresses

Primary practice location

64 Market SQ
Newington, CT 06111-2911

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
I20241024002509 CT Practitioner - Physical Therapist in Private Practice 7810420197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anb-Ptsma Holdings IncGroup PAC ID 4789572926, 190 clinicians

Practice addresses (Care Compare)

64 Market SQ
Newington, CT 06111-2911
Phone (860) 881-2928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14598CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Sacred Heart University, Inc Physical Therapist PastSince Sep 29, 2024 Accepting new patients

Locations

64 Market Sq
Newington, CT 06111
Phone (860) 881-2928

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 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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1811714801",
    "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": "64 MARKET SQ",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112911",
            "telephone_number": "860-881-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRTUDES",
        "first_name": "SHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.