Individual provider Active NPI

Paul Matthew Oberle, PT

  • Physical Therapist
  • Manchester, CT
National Provider Identifier
1891732830
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006775 Issued in CT
Practice address
155 Main St
Manchester, CT 06042-3126
Phone
(860) 647-0336
Fax
(860) 647-9873
NPI assigned
May 31, 2006
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006775 CT Primary

Addresses

Primary practice location

155 Main St
Manchester, CT 06042-3126

Mailing address

1579 Straits Tpke
Middlebury, CT 06762-1835
Phone (203) 577-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040105000310 CT Practitioner - Physical Therapist in Private Practice 2163321688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Score, LLCGroup PAC ID 0749268175, 7 clinicians

Practice addresses (Care Compare)

1579 Straits Tpke
Middlebury, CT 06762-1841
Phone (203) 577-2002

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
83.33
Improvement activities
40
Cost
91.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006775CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Score, LLC Physical Therapist CurrentSince Sep 28, 2015 Accepting new patients
Active Orthopedic Therapy PC Physical Therapist Past Accepting new patients

Locations

155 Main St
Manchester, CT 06042
Phone (860) 647-0336

1579 Straits Tpke
Middlebury, CT 06762
Phone (203) 577-2002

82 Providence St
Putnam, CT 06260
Phone (860) 315-9123

2 Pomperaug Office Park
Ste 303
Southbury, CT 06488
Phone (203) 264-1735

51 Sherman Hill Rd
Ste A201
Woodbury, CT 06798
Phone (203) 263-3104

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1891732830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-577-2002",
            "fax_number": "203-577-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060423126",
            "telephone_number": "860-647-0336",
            "fax_number": "860-647-9873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERLE",
        "first_name": "PAUL",
        "middle_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "006775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.