NPIMap

Organization Active NPI

Performance Physical Therapy of Westport LLC

  • Physical Therapist
  • Westport, CT
National Provider Identifier
1972809036
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PERFORMANCE PHYSICAL THERAPY OF WESTPORT LLC
Practice address
333 Post Rd W
Westport, CT 06880-4701
Phone
(203) 422-0679
Fax
(203) 422-0931
NPI assigned
Feb 7, 2011
Organization subpart
Yes
Parent organization
PERFORMANCE HEALTH CARE MANAGEMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Mr. Todd Wilkowski
Title
Owner
Phone
(203) 422-0679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

333 Post Rd W
Westport, CT 06880-4701

Mailing address

9 W Broad St Ste 100
Stamford, CT 06902-3764
Phone (203) 557-9165

Other practice location 1

508 Westport Ave
Norwalk, CT 06851-4424
Phone (203) 557-9165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140227000723 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2567698756 Receives reassigned benefits from 17 practitioners
Practice locations: Norwalk, CT

National Provider Directory

National Provider Directory
Part of
Performance Health Care Management

Locations

508 Westport Ave
Norwalk, CT 06851
Phone (203) 553-7626

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1972809036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W BROAD ST STE 100",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023764",
            "telephone_number": "203-557-9165",
            "fax_number": "203-625-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 POST RD W",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068804701",
            "telephone_number": "203-422-0679",
            "fax_number": "203-422-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Westport Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068514424",
            "country_code": "US",
            "telephone_number": "203-557-9165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY OF WESTPORT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERFORMANCE HEALTH CARE MANAGEMENT",
        "enumeration_date": "2011-02-07",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "WILKOWSKI",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-422-0679",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.