Austin Bronson
Individual provider Active NPI Physical Therapist · Wallingford, CT
NPI 1831667070 · NPPES record last updated Nov 6, 2018
Key facts
- NPI
- 1831667070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 12062 (CT)
- Practice address
- 101 N Plains Industrial Rd
Wallingford, CT 06492-2360 - Phone
- (203) 265-0018
- Fax
- (203) 264-0199
- NPI assigned
- Nov 6, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivyrehab Connecticut Inc
Practice addresses (Care Compare)
101 N Plains Industrial Rd
Wallingford, CT 06492-2360
Phone (203) 265-0018
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181115000164 | CT | Practitioner - Physical Therapist in Private Practice | 9638423387 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Connecticut, Inc. | Physical Therapist | Current |
Accepting new patients |
Locations
101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018
500 Chase Pkwy
Fl 1
Waterbury, CT 06708
Phone (203) 754-2266
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12062 | CT | Yes |
Addresses
Primary practice location
101 N Plains Industrial Rd
Wallingford, CT 06492-2360
Mailing address
1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200
Other providers in Wallingford, CT
- Bridge Center for Healing
- Kelly S Bristol
- Broad Street Dental
- Derrick Brockamer
- Linda A Brogan
- Brook Hollow Health Care Center LLC
- Vanessa Browne
- Ashley White Brzezinski
- Patricia Kersulis Buckley
- Terrence Bugai
All providers in Wallingford, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.