Jacqueline Birdsall, DPT
Individual provider Active NPI Physical Therapist · Orange, CT
NPI 1871023697 · NPPES record last updated Jan 17, 2022
Key facts
- NPI
- 1871023697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 14.011404 (CT)
- Practice address
- 400 Boston Post Rd
Orange, CT 06477-3545 - Phone
- (203) 799-3343
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ronai Physical Therapy and Sports Medicine LLC
Practice addresses (Care Compare)
400 Boston Post Rd
Orange, CT 06477-3545
Phone (203) 799-3343
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170818001591 | CT | Practitioner - Physical Therapist in Private Practice | 6608148051 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronai Physical Therapy & Sports Medicine, LLC | Physical Therapist | Current |
Accepting new patients |
| Sacred Heart University, Inc | Physical Therapist | Past | Accepting new patients |
| Integrated Rehabilitation Services, LLC | Physical Therapist | Past |
Accepting new patients |
Locations
400 Boston Post Rd
Orange, CT 06477
Phone (203) 799-3343
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14.011404 | CT | Yes |
Addresses
Primary practice location
400 Boston Post Rd
Orange, CT 06477-3545
Mailing address
400 Boston Post Rd
Orange, CT 06477-3545
Phone (203) 799-3343
Other names
- Jacqueline Ristow
Other providers in Orange, CT
- Joanna Adela Berardesca
- Janet Berkley
- Lindsey Bernacchia
- Makayla Bigard
- Oresta Bilous
- Sandra Blinn
- Bo Acupuncture Healing, LLC
- Julianne Boggs
- Rebecca Bonetti
- Patricia Borrelli
All providers in Orange, 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 Jan 17, 2022. 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.