Individual provider Active NPI

Madison Dacey

  • Physical Therapist
  • San Clemente, CA
National Provider Identifier
1003661240
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27864 Issued in MA
Practice address
415 E Avenida Pico Ste M
San Clemente, CA 92672-3800
Phone
(949) 245-6581
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27864 MA Primary

Addresses

Primary practice location

415 E Avenida Pico Ste M
San Clemente, CA 92672-3800

Mailing address

2600 Dallas Pkwy Ste 290
Ste 290
Frisco, TX 75034-7493
Phone (508) 385-4212

Other practice location 1

860 Route 134 Ste 5&6
South Dennis, MA 02660-2577
Phone (508) 385-4212

Other identifiers 1

IdentifierTypeStateIssuer
PT310205OtherCAPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241102000216 MA Practitioner - Physical Therapist in Private Practice 1951834639 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

1343 Boston Providence Tpke
Norwood, MA 02062-5055
Phone (781) 702-1339

205 Worcester CT
Suite 3B
Falmouth, MA 02540-3920
Phone (774) 349-0026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27864MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Sep 3, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Sep 3, 2024 Accepting new patients
Bay State Physical Therapy of Randolph Inc CurrentSince Nov 24, 2025 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Nov 24, 2025 Accepting new patients
Physiotherapy Associates Inc PastSince Apr 1, 2024 Accepting new patients

Locations

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

860 Route 134
Ste 5
South Dennis, MA 02660
Phone (508) 385-4212

860 Route 134
Ste 56
South Dennis, MA 02660
Phone (508) 385-4212

Organizations & group practices 6

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1003661240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 DALLAS PKWY STE 290",
            "address_2": "STE 290",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347493",
            "telephone_number": "508-385-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E AVENIDA PICO STE M",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723800",
            "telephone_number": "949-245-6581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Route 134 Ste 5&6",
            "address_purpose": "LOCATION",
            "city": "South Dennis",
            "state": "MA",
            "postal_code": "026602577",
            "country_code": "US",
            "telephone_number": "508-385-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACEY",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT310205",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.