Active NPI
Michael Anthony Roy, PTA
- Physical Therapy Assistant
- Middletown, CT
National Provider Identifier
1881979409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 000611
- Practice address
- 600 Highland Ave
Middletown, CT 06457-5151 - Phone
- (860) 347-3315
- Fax
- (860) 344-8068
- NPI assigned
- Oct 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 000611 | CT | Primary |
Addresses
Primary practice location
600 Highland Ave
Middletown, CT 06457-5151
Mailing address
600 Highland Ave
Middletown, CT 06457-5151
Phone (860) 347-3315
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000611 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1881979409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064575151",
"telephone_number": "860-347-3315",
"fax_number": "860-344-8068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064575151",
"telephone_number": "860-347-3315",
"fax_number": "860-344-8068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-14",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CT",
"license": "000611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.