Ethan Tyler Pearson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14652 Issued in CT

Practice address

1231 Farmington Ave
Berlin, CT 06037-2301

Phone

(860) 827-1333

NPI assigned

Aug 9, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ptsma, Inc.

  • Physical Therapy Clinic/Center
  • Pawcatuck, CT
  • NPI 1033773759

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ptsma Inc

  • Physical Therapy Clinic/Center
  • Manchester, CT
  • NPI 1619393337
  NPD
• Ptsma, Inc.

  • Physical Therapy Clinic/Center
  • Newington, CT
  • NPI 1508322272

  Physical Therapist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1821829037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 REDWOOD DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102417",
            "telephone_number": "860-385-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 FARMINGTON AVE",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372301",
            "telephone_number": "860-827-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "ETHAN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil A Palker, M.D.
• Asa Paradis
• Paragon Behavioral Health, LLC
• Leonard Pare, PT
• Kyle Parisi
• Dallas Peery
• Christina Perez Burby, LMFT
• Robin Perron, PT
• Dennis Karl Pezzolesi Jr., D.M.D.
• Merideth Pine

• Physical Therapist in Berlin, CT
• Providers in Berlin, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.