Formula for Performance & Rehab, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FORMULA FOR PERFORMANCE & REHAB, LLC

Practice address

59 Valley Forge Rd
Weston, CT 06883-1912

Phone

(203) 227-6666

NPI assigned

Aug 7, 2014

Last updated

Aug 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas Corwin

Title

Managing Director

Phone

(203) 247-2270

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin N Baldeo, PT

  • Physical Therapist
  • Norwalk, CT
  • NPI 1235565417
  Medicare reassignment NPD

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1992114508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 VALLEY FORGE RD",
            "city": "WESTON",
            "state": "CT",
            "postal_code": "068831912",
            "telephone_number": "203-227-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 VALLEY FORGE RD",
            "city": "WESTON",
            "state": "CT",
            "postal_code": "068831912",
            "telephone_number": "203-227-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMULA FOR PERFORMANCE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "CORWIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "203-247-2270"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Ellis, M.D.
• Judith R. Epstein, PH.D.
• Eve Applebaum, Psychotherapist
• Jacqueline Fidelman
• Kathleen B Fitzgerald, LMFT
• Michele Anderson Friedman
• Ann Garvey
• Luke T Garvey, LCSW
• Mark Goldenberg, DC
• Katherine Ann Griffin

• Physical Therapist in Weston, CT
• Providers in Weston, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.