Individual provider Active NPI

Michelle Tsirovasiles, PT

  • Physical Therapist
  • Glastonbury, CT
National Provider Identifier
1962468272
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007460 Issued in CT
Practice address
84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468
Phone
(860) 633-6292
Fax
(860) 633-6299
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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 007460 CT Primary

Addresses

Primary practice location

84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468

Mailing address

84 Glastonbury Blvd
Suite 103
Glastonbury, CT 06033-4468
Phone (860) 633-6292

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080415000563 CT Practitioner - Physical Therapist in Private Practice 8224116363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolton Physical Therapy and Sports Performance LLCGroup PAC ID 4688839855, 2 clinicians

Practice addresses (Care Compare)

921 Boston Tpke
Bolton, CT 06043-7403
Phone (860) 646-8758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007460CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bolton Physical Therapy & Sports Performance LLC CurrentSince Jun 12, 2021 Accepting new patients
SFH-FF,LLC Physical Therapist Past Accepting new patients

Locations

921 Boston Tpke
Bolton, CT 06043
Phone (860) 646-0649

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1962468272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 GLASTONBURY BLVD",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334468",
            "telephone_number": "860-633-6292",
            "fax_number": "860-633-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 GLASTONBURY BLVD",
            "address_2": "SUITE 103",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334468",
            "telephone_number": "860-633-6292",
            "fax_number": "860-633-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSIROVASILES",
        "first_name": "MICHELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "007460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.