Individual provider Active NPI

Michael Moschella, DPT, ATC

  • Physical Therapist
  • New London, CT
National Provider Identifier
1942433776
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8605 Issued in CT
Practice address
6 Shaws CV
Suite 101
New London, CT 06320-4969
Phone
(860) 447-3009
Fax
(860) 447-1320
NPI assigned
Aug 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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 8605 CT Primary

Addresses

Primary practice location

6 Shaws CV
Suite 101
New London, CT 06320-4969

Mailing address

6 Shaws CV
Suite 101
New London, CT 06320-4969
Phone (860) 447-3009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091009000166 CT Practitioner - Physical Therapist in Private Practice 2668518309 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8605CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inspire Physical Therapy and Wellness, LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Carlson Therapy Network, PC Physical Therapist CurrentSince Dec 4, 2012 Accepting new patients
Integrated Rehabilitation Services Limited Partnership Physical Therapist Past Accepting new patients

Locations

1353 Gold Star Hwy
#213
Groton, CT 06340
Phone (401) 600-1683

816 Broad St
Meriden, CT 06450
Phone (203) 238-1334

6 Shaws Cv
Ste 101
New London, CT 06320
Phone (860) 444-9022

116 Danbury Rd
New Milford, CT 06776
Phone (203) 794-6331

116 Danbury Rd
Ste 5
New Milford, CT 06776
Phone (860) 354-7605

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1942433776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SHAWS CV",
            "address_2": "SUITE 101",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204969",
            "telephone_number": "860-447-3009",
            "fax_number": "860-447-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SHAWS CV",
            "address_2": "SUITE 101",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204969",
            "telephone_number": "860-447-3009",
            "fax_number": "860-447-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCHELLA",
        "first_name": "MICHAEL",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "8605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.