Individual provider Active NPI

Dena Goldberg, MSPT

  • Physical Therapist
  • Rutland, VT
National Provider Identifier
1821213836
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040.0003749 Issued in VT
Practice address
155 Woodstock Ave
Rutland, VT 05701-3587
Phone
(027) 727-8018
Fax
(802) 855-8698
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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 040.0003749 VT Primary

Addresses

Primary practice location

155 Woodstock Ave
Rutland, VT 05701-3587

Mailing address

32 Hemlock St
Manchester, CT 06040-4016

Other names 1

  • Dena Baram Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620000020 VT Practitioner - Physical Therapist in Private Practice 9436440633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Every Body PT LLCGroup PAC ID 9537495320, 4 clinicians

Practice addresses (Care Compare)

155 Woodstock Ave
Suite 2
Rutland, VT 05701-3587
Phone (802) 772-7801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040.0003749VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Every Body PT LLC Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Select Physical Therapy of Connecticut Limited Partnership Physical Therapist Past Accepting new patients
Sports and Orthopedic Rehabilitation Services Inc Past Accepting new patients

Locations

155 Woodstock Ave
Ste 2
Rutland, VT 05701
Phone (415) 533-4863

155 Woodstock Ave
Rutland, VT 05701
Phone (802) 747-9100

Organizations & group practices 3

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1821213836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HEMLOCK ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WOODSTOCK AVE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057013587",
            "telephone_number": "027-727-8018",
            "fax_number": "802-855-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DENA",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0003749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENA",
            "last_name": "BARAM",
            "credential": "MSPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.