Travis Moran, DPT
Individual provider Active NPI Physical Therapist · Columbia, CT
NPI 1962895615 · NPPES record last updated Mar 5, 2015
Key facts
- NPI
- 1962895615
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 010404 (CT)
- Practice address
- 106 Route 66 East
Columbia, CT 06237 - Phone
- (860) 228-0194
- Fax
- (860) 228-2694
- NPI assigned
- Mar 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crossroads Physical Therapy LLC
Practice addresses (Care Compare)
106 Route 66 E
Columbia, CT 06237-1224
Phone (860) 228-0194
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150508000333 | CT | Practitioner - Physical Therapist in Private Practice | 0042539330 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
106 Route 66 E
Columbia, CT 06237
Phone (860) 228-0194
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 010404 | CT | Yes |
Addresses
Primary practice location
106 Route 66 East
Columbia, CT 06237
Mailing address
106 Route 66 E
Columbia, CT 06237-1224
Phone (860) 228-0194
Other providers in Columbia, CT
- Julia Mendes
- Kurt Banning Mias
- Sherry L. Michaud
- Laureen Moran
- Stephen M Moran
- Zachary Moran
- New England Holistic Well-Being Center LLC
- Dawn Marie Orzolek
- Jarlyn Phillips
- Elisa Marie Quesada
All providers in Columbia, 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 Mar 5, 2015. 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.