Individual provider Active NPI

Raymond Timothy Ryan, PT

  • Physical Therapist
  • Meriden, CT
National Provider Identifier
1821034117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006372 Issued in CT
Practice address
455 Lewis Ave
Meriden, CT 06451-2121
Phone
(203) 935-0463
Fax
(203) 639-7997
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 006372 CT Primary

Addresses

Primary practice location

455 Lewis Ave
Meriden, CT 06451-2121

Mailing address

455 Lewis Ave
Meriden, CT 06451-2121
Phone (203) 935-0463

Other identifiers 1

IdentifierTypeStateIssuer
004214128MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061215000036 CT Practitioner - Physical Therapist in Private Practice 2668471988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

863 N Main St Ext
Suite 200 FL 2
Wallingford, CT 06492-2434
Phone (203) 265-3280

Merit-based Incentive Payment System (MIPS)

Final score
71.79 of 100Reported as individual
Quality
50.34
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6372CTMDClinical Social Worker
006372CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Orthopedics & Musculoskeletal Care LLC CurrentSince Sep 11, 2006 Accepting new patients
Carlson Therapy Network, PC Physical Therapist PastSince May 1, 2021 Accepting new patients
Valley Physical Therapy & Sports Medicine Services, P.C. Physical Therapist PastSince Apr 26, 2012 Accepting new patients
Valley Physical Therapy, LLC Past Accepting new patients

Locations

455 Lewis Ave
Ste 101
Meriden, CT 06451
Phone (203) 639-7992

455 Lewis Ave
Meriden, CT 06451
Phone (203) 238-2691

455 Lewis Ave
Ste 200
Meriden, CT 06451
Phone (203) 238-9446

98 Main St
Rear 1
Southington, CT 06489

601 N Main St
Southington, CT 06489

863 N Main Street Ext
Ste 200
Wallingford, CT 06492
Phone (203) 741-6547

Organizations & group practices 4

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821034117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-935-0463",
            "fax_number": "203-639-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-935-0463",
            "fax_number": "203-639-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "RAYMOND",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004214128",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.