NPIMap

Individual provider Active NPI

Edward David Segel, PT

  • Orthopedic Physical Therapist
  • Brookline, MA
National Provider Identifier
1003060526
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
18216 Issued in MA
Practice address
524 Harvard St
Brookline, MA 02446-2463
Phone
(617) 731-1004
Fax
(617) 731-1001
NPI assigned
Nov 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 18216 MA Primary

Addresses

Primary practice location

524 Harvard St
Brookline, MA 02446-2463

Mailing address

524 Harvard St
Brookline, MA 02446-2463
Phone (617) 731-1004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090209000533 MA Practitioner - Physical Therapist in Private Practice 7113082090 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18216MAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Physical Therapy CurrentSince Jun 4, 2021 Accepting new patients
Eastern Physical Therapy Orthopedic CurrentSince Jun 4, 2021 Accepting new patients
Az Physical Therapy Corporation Orthopedic PastSince Aug 1, 2016 Accepting new patients
Boston Pain & Rehab Center,Inc Past Accepting new patients
Back and Balance Rehabilitation Center Past Accepting new patients
Physical Therapy of Mattapan Square, LLC PastSince Dec 10, 2012 Accepting new patients
Barron Chiropractic and Rehabilitation PC PastSince Aug 19, 1996 Accepting new patients
Be Pain Free PT Inc Orthopedic PastSince Apr 1, 2014 Accepting new patients

Locations

100 Everett Ave
#3A
Chelsea, MA 02150
Phone (617) 947-2474

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1003060526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462463",
            "telephone_number": "617-731-1004",
            "fax_number": "617-731-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462463",
            "telephone_number": "617-731-1004",
            "fax_number": "617-731-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGEL",
        "first_name": "EDWARD",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-11",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "18216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.