Individual provider Active NPI

Bailey William Fernandes, DPT

  • Physical Therapist
  • Manchester, CT
National Provider Identifier
1841912599
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
586 Middle Tpke E
Manchester, CT 06040-3730
Phone
(860) 645-3814
NPI assigned
Sep 19, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 Primary

Addresses

Primary practice location

586 Middle Tpke E
Manchester, CT 06040-3730

Mailing address

435 Hartford Tpke Ste U
Vernon Rockville, CT 06066-4834
Phone (860) 979-1611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010002986 CT Practitioner - Physical Therapist in Private Practice 4587040829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Services Limited PartnershipGroup PAC ID 8426428129, 49 clinicians

Practice addresses (Care Compare)

435 Hartford Tpke
Suite U
Vernon, CT 06066-4834
Phone (860) 870-8272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services, LLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

586 Middle Tpke E
Manchester, CT 06040
Phone (860) 645-3810

230 Mountain Rd
Fl 2
Suffield, CT 06078
Phone (860) 668-9589

435 Hartford Tpke
Ste U
Vernon Rockville, CT 06066
Phone (860) 870-8272

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1841912599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 HARTFORD TPKE STE U",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060664834",
            "telephone_number": "860-979-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 MIDDLE TPKE E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403730",
            "telephone_number": "860-645-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "BAILEY",
        "middle_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.