John Michael Dufresne

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

002017 Issued in CT

Practice address

12 Village Street
Suite 10
North Haven, CT 06473

Phone

(203) 562-8140

Fax

(203) 562-7265

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 5

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Village Street Physical Therapy and Sports Medicine P.C.

  • Physical Therapist
  • North Haven, CT
  • NPI 1548441090
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881705291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 VILLAGE STREET",
            "address_2": "SUITE 10",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-562-8140",
            "fax_number": "203-562-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 VILLAGE STREET",
            "address_2": "SUITE 10",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-562-8140",
            "fax_number": "203-562-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRESNE",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "002017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V1735",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "080002017CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "897715",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A531345",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "37401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruel Dixon, BCBA
• Ashlee Doherty, DNP, FNP
• Danielle Dombroski
• Domus Realtors & Associates LLC (Domus Care)
• Richard Downey, LPC
• Sarah A Dunbar, PA
• Richard Wilbrod Durocher, DPM
• Hannah Dwyer
• Sally Dzurilla, OTR/L
• Ear Nose & Throat Medical and Surgical Group, LLC

• Physical Therapist in North Haven, CT
• Providers in North Haven, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.