Active NPI
Roland J Perreault, PT
- Physical Therapist
- Watertown, CT
National Provider Identifier
1871678045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3018
- Practice address
- 27 Depot St
Watertown, CT 06795-2601 - Phone
- (860) 274-1487
- Fax
- (860) 274-9730
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3018 | CT | Primary |
Addresses
Primary practice location
27 Depot St
Watertown, CT 06795-2601
Mailing address
27 Depot St
Watertown, CT 06795-2601
Phone (860) 274-4092
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080003018CT06 | Other | CT | ANTHEM BC BS |
| 080003018CT07 | Other | CT | ANTHEM BC BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart University, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Fairfield, CT
- NPI 1154678928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206835200000",
"number": "1871678045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 DEPOT ST",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067952601",
"telephone_number": "860-274-4092",
"fax_number": "860-274-4099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 DEPOT ST",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067952601",
"telephone_number": "860-274-1487",
"fax_number": "860-274-9730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERREAULT",
"first_name": "ROLAND",
"middle_name": "J",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2008-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "3018",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "080003018CT06",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC BS",
"identifier": "080003018CT07",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.