Devon Dusseault, PT, DPT
Individual provider Active NPI Physical Therapist · East Granby, CT
NPI 1861168437 · NPPES record last updated Mar 10, 2026
Key facts
- NPI
- 1861168437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 013350 (CT)
- Practice address
- 14 Airport Park Rd
East Granby, CT 06026-9523 - Phone
- (860) 245-8914
- Fax
- (860) 957-2364
- NPI assigned
- Aug 23, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
14 Airport Park Rd
East Granby, CT 06026-9523
Phone (860) 245-8914
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211013000558 | MA | Practitioner - Physical Therapist in Private Practice | 7618375239 | |
| I20240124002043 | CT | Practitioner - Physical Therapist in Private Practice | 7618375239 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013350 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fortify Wellness and Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Connecticut CVS Pharmacy LLC | Past |
Accepting new patients |
Locations
14 Airport Park Rd
East Granby, CT 06026
Phone (860) 245-8914
3 Turkey Hills Rd
East Granby, CT 06026
3 Turkey Hills Rd
#3S
East Granby, CT 06026
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 013350 | CT | Yes |
Addresses
Primary practice location
14 Airport Park Rd
East Granby, CT 06026-9523
Mailing address
14 Airport Park Rd
East Granby, CT 06026-9523
Phone (860) 245-8914
Other providers in East Granby, CT
- Jeannie M Crabtree
- Elizabeth Jean Davis
- Kimberly Diane Davis
- Trinity Dejesus
- Steven R Dieterich
- East Granby Ambulance Assn
- East Granby Board of Education
- East Granby Family Practice LLC
- Educational Advancement Associates
- Ellsworth Medical, LLC
All providers in East Granby, 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 Mar 10, 2026. 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.