Individual provider Active NPI

Daniell Anthony Pagaduan

  • Physical Therapy Assistant
  • Wallingford, CT
National Provider Identifier
1881272979
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2098 Issued in CT
Practice address
7 Jenna Rd
Wallingford, CT 06492-2905
Phone
(201) 713-7183
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2098 CT Primary

Addresses

Primary practice location

7 Jenna Rd
Wallingford, CT 06492-2905

Mailing address

7 Jenna Rd
Wallingford, CT 06492-2905
Phone (201) 713-7183

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2098CTMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1881272979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 JENNA RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922905",
            "telephone_number": "201-713-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 JENNA RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922905",
            "telephone_number": "201-713-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGADUAN",
        "first_name": "DANIELL",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "2098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.