NICOLE ELLROD (PT) – Physical Therapist, NPI 1043305436

NICOLE ELLROD (PT) is a healthcare provider. based in Granby, Connecticut. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 007745 (CT). The NPI Number for NICOLE ELLROD (PT) is 1043305436

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE ELLROD (PT)
NPI
1043305436
Phone
(860) 844-8912
Address
97 SALMON BROOK ST
Enumeration Date
3 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8604132727
Graduation Year
2003 (23 years ago)
PAC ID
0446565360
Group Practice PAC ID
2365781762
Professional Enrollment ID
I20150820010910
Address ID
CT060922407WE244XXRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,335 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CT

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Provider Addresses for NICOLE ELLROD (PT)

  • 97, Salmon Brook Street, Chatsworth Village, Granby, Capitol Planning Region, Connecticut, 06035, United States

    GRANBY, CT 06035

    Phone: (860) 844-8912

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150820010910IPhysical Therapist In Private PracticeCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes8711$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes8211$0
View full utilization report →

Insurance plans in this area (ZIP 06035)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365781762View full group profile
NameSpecialtyState
C H I R O P R A C T I CCT

Reviews

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Frequently asked questions

What federal number belongs to NICOLE ELLROD (PT)?
The federal identifier for NICOLE ELLROD (PT) is NPI 1043305436.
Is NICOLE ELLROD (PT) currently active in the NPI registry?
CMS-published data lists NICOLE ELLROD (PT) as an active registrant.
Does NICOLE ELLROD (PT) list a primary specialty?
If you are matching referrals, note Physical Therapist for NICOLE ELLROD (PT). Clinical services aligned with this taxonomy classification.
What location metadata exists for NICOLE ELLROD (PT)?
The page summarizes Granby, Connecticut for NICOLE ELLROD (PT); expand the address list for detail.
How can I contact NICOLE ELLROD (PT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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