Nicholas Harrison Bonoff, DPT
Individual provider Active NPI Physical Therapist · Terryville, CT
NPI 1922761964 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1922761964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 013271 (CT)
- Practice address
- 311 Main St
Terryville, CT 06786-5928 - Phone
- (860) 506-4124
- Fax
- (860) 845-8197
- NPI assigned
- Oct 18, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ivyrehab Connecticut Inc
Orthopaedic and Neurosurgery Specialists, PLLC
Practice addresses (Care Compare)
3 Federal Rd
Brookfield, CT 06804-2505
Phone (203) 456-1010
6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211119000657 | CT | Practitioner - Physical Therapist in Private Practice | 6507255130 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013271 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Rehab PC | Physical Therapist | Current |
Accepting new patients |
| Ivyrehab Connecticut, Inc. | Physical Therapist | Current |
Accepting new patients |
| Orthopaedic & Neurosurgery Specialists, PLLC | Physical Medicine & Rehabilitation | Current |
Accepting new patients |
| Orthopaedic & Neurosurgery Specialists, PLLC | Current |
Accepting new patients | |
| Community Physical Therapy | Physical Therapist | Past | Accepting new patients |
Locations
3 Federal Rd
Ste 100
Brookfield, CT 06804
Phone (203) 456-1010
3 Federal Rd
Brookfield, CT 06804
Phone (203) 456-1010
22 Eagle Rd
Danbury, CT 06810
Phone (203) 218-5303
6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145
101 N Plains Rd
Wallingford, CT 06492
Phone (203) 265-0018
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 013271 | CT | Yes |
Addresses
Primary practice location
311 Main St
Terryville, CT 06786-5928
Mailing address
176 Laning St
Southington, CT 06489-1603
Phone (860) 540-4184
Other practice location 1
6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145
Other providers in Terryville, CT
- William Alberti
- Karen Lynn Anulewicz
- Beacon Prescriptions Terryville
- Thea Bernabe
- Taylor Binette
- Amanda Byrnes
- Robert B Cavoli
- Joseph T Cherneskie
- Mark Cho
- Elizabeth Colaianni
All providers in Terryville, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.