Kevin T Russell, BS, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4359 Issued in CT

Practice address

111 Goose Lane
Ste 2500
Guilford, CT 06437

Phone

(203) 453-0134

Fax

(203) 453-0167

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Connecticut School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ptsma IncGroup PAC ID 7911800180, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• Ptsma, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Pawcatuck, CT
  • NPI 1033773759

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ptsma Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Manchester, CT
  • NPI 1619393337
  NPD
• Ptsma, Inc.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Newington, CT
  • NPI 1508322272

  Physical Therapist

  NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Guilford, CT
  • NPI 1871548768

  Physical Therapist

  NPD (past)
• Physiotherapy Associates, Inc.

  • Physical Therapy Clinic/Center
  • Monroe, CT
  • NPI 1235408840

  Physical Therapist

  NPD (past)
• Valley Physical Therapy & Sports Medicine Services, P.C.

  • Physical Therapist
  • Marlborough, CT
  • NPI 1841381969
  NPD (past)
• Valley Physical Therapy, LLC

  • Specialist
  • Marlborough, CT
  • NPI 1841525904
  NPD (past)
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1881601318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GOOSE LANE",
            "address_2": "SUITE 2500",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "06437",
            "telephone_number": "203-453-0134",
            "fax_number": "203-453-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GOOSE LANE",
            "address_2": "STE 2500",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "06437",
            "telephone_number": "203-453-0134",
            "fax_number": "203-453-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "BS, MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "4359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "080004359CT04",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004133906",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Louise Rotnem, PHD, LICSW
• Steven Rozea, P.T.
• Elizabeth Rubbo, DPT
• Elizabeth B. Rubin, M.S., L.C.S.W.
• Richard Lloyd Rubin, MD
• Paula F Sabino, APRN,BC
• Nicholas Paul Saggese, D.M.D.
• David Salomon, D.D.S.
• Salt, Sand, & Speech
• Cassandra Sanchez

• Physical Therapist in Guilford, CT
• Providers in Guilford, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.