Omni Physical & Aquatic Therapy Center, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

OMNI PHYSICAL & AQUATIC THERAPY CENTER, INC

Doing business as

Omni Medical

Practice address

8 Research Pkwy
Wallingford, CT 06492-1929

Phone

(203) 294-1998

Fax

(203) 294-1189

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Trisha Ann Mahoney-Randall

Title

Billing Manager

Phone

(203) 877-0112

Specialties & licenses 9

Addresses

Other identifiers 9

Other names 1

• Omni Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Outpatient physical therapy / speech pathology certification: CCN 076561

Legal name

OMNI PHYSICAL & AQUATIC THERAPY CENTER, INC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Aug 8, 1996

Last certification

Mar 20, 2019

Ownership / control type

Proprietary

Facility address

8 Research Pkwy
Wallingford, CT 06492

Locations

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Henry Davis, D.C.

  • Chiropractor
  • Milford, CT
  • NPI 1568716926
  Medicare reassignment Care Compare group NPD
• Awilda Figueroa, DC

  • Chiropractor
  • West Haven, CT
  • NPI 1467589580
  Medicare reassignment Care Compare group
• Erik B Reich, D.C.

  • Chiropractor
  • Cheshire, CT
  • NPI 1194080036
  Medicare reassignment
• Mindi Steinhardt, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • New Haven, CT
  • NPI 1417069543
  Medicare reassignment
• Frank John Forte, D.C

  • Chiropractor
  • Milford, CT
  • NPI 1336207497
  NPD
• Bryan Wade Barry, DC

  • Chiropractor
  • Hamden, CT
  • NPI 1821105735
  NPD (past)
• Marla J Colburn Dunnells, D.C.

  • Chiropractor
  • Glastonbury, CT
  • NPI 1114954930
  NPD (past)
• Ralph Anthony Criscuolo, DC CC SP

  • Chiropractor
  • North Haven, CT
  • NPI 1316029424
  NPD (past)
• Eric Douglas Meyers, D.C.

  • Chiropractor
  • Hamden, CT
  • NPI 1053350355
  NPD (past)
• Steven Joseph O'Donnell, DC

  • Sports Physician Chiropractor
  • Meriden, CT
  • NPI 1669529962
  NPD (past)
• Vincent Quarato, D.C.

  • Chiropractor
  • New Haven, CT
  • NPI 1144388935
  NPD (past)
• Kathleen M Romania, OT05231966

  • Ergonomics Occupational Therapist
  • Wallingford, CT
  • NPI 1336284751
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861537995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RESEARCH PKWY",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921929",
            "telephone_number": "203-294-1998",
            "fax_number": "203-294-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RESEARCH PKWY",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064921929",
            "telephone_number": "203-294-1998",
            "fax_number": "203-294-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI PHYSICAL & AQUATIC THERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-21",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "MAHONEY-RANDALL",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "203-877-0112"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6404254",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A667399",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY PLAN",
            "identifier": "004173184",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "712712",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004173184",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004255271",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V1691",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "183158",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "552470",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stefanie Olivares
• Stacey Lauren Oliveto, PHARMD
• Alexa Olko, DPT
• Erik Olsen, PT
• Omni Health
• Maegan Anabel Onofrio
• Optum Infusion Services 500, Inc.
• Alexis Orlando, PT, DPT
• Aaron E Padden, FNP
• Allison Padegimas, M.D.

• Physical Medicine & Rehabilitation Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.