JENALYN D VERGARA (PT) – Physical Therapist, NPI 1083198790

JENALYN D VERGARA (PT) is a healthcare provider. based in Mystic, Connecticut. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 008043 (CT). The NPI Number for JENALYN D VERGARA (PT) is 1083198790

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
JENALYN D VERGARA (PT)
NPI
1083198790
Phone
(631) 882-5464
Address
29 ENSIGN DR
Enumeration Date
18 September 2018
Last Update Date
18 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4016001863
Graduation Year
1999 (27 years ago)
PAC ID
0840799763
Group Practice PAC ID
4688073448
Professional Enrollment ID
I20250818003486
Address ID
CT064432708MA63XXXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,335 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CT

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Provider Addresses for JENALYN D VERGARA (PT)

  • 29 ENSIGN DR

    MYSTIC, CT 063551530

    Phone: (631) 882-5464

    Type: Mailing

  • 186, Jerry Browne Road, Mystic, Stonington, New London County, Connecticut, 06355, United States

    MYSTIC, CT 063554004

    Phone: (860) 572-5675

    Type: Location

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: 2025-08-18

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
I20250818003486IPhysical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06355)

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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: 4688073448View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeRI
Occupational Therapist In Private PracticeTX
Occupational Therapist In Private PracticeCT
Qualified Speech Language PathologistRI
Occupational Therapist In Private PracticeRI
Occupational Therapist In Private PracticeRI

Reviews

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Frequently asked questions

Where can patients find JENALYN D VERGARA (PT)'s NPI?
You can confirm JENALYN D VERGARA (PT) with NPI 1083198790; it appears in the national provider directory.
Is JENALYN D VERGARA (PT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does JENALYN D VERGARA (PT) work in?
You can think of JENALYN D VERGARA (PT) as practicing within Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place JENALYN D VERGARA (PT)?
The snapshot lists Mystic, Connecticut for JENALYN D VERGARA (PT); download NPPES for the complete set.
Is JENALYN D VERGARA (PT) a real provider?
This page reflects official NPPES data for NPI 1083198790. Always confirm identity and privileges with the practice and licensing boards.

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