Second Wind Physical Therapy & Sports Medicine Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15139 Issued in MA

Legal business name

SECOND WIND PHYSICAL THERAPY & SPORTS MEDICINE INC.

Practice address

115 Porter St
East Boston, MA 02128-2110

Phone

(617) 569-2929

Fax

(617) 569-2925

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Brendon Lachance, MS, PTNPI 1275535288

Title

President

Phone

(617) 429-2042

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brendon Daniel Lachance, MS, PT

  • Physical Therapist
  • East Boston, MA
  • NPI 1275535288
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1013106483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PORTER ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021282110",
            "telephone_number": "617-569-2929",
            "fax_number": "617-569-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PORTER ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021282110",
            "telephone_number": "617-569-2929",
            "fax_number": "617-569-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND WIND PHYSICAL THERAPY & SPORTS MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "LACHANCE",
        "authorized_official_first_name": "BRENDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-429-2042",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330299",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Schiavone, LICSW
• Peter Schindler, MSW
• Seth N Schonwald, M.D.
• Pamela Mae Schuster, CNP
• Barbara B Searles, LICSW
• Ricardo Juan Sedan, FNP
• Deborah Seiberg, LMHC
• Nancy B Seigal, RNP
• Margerie Serrano
• Joanne Sewell, LCSW, LADC1

• Physical Therapist in East Boston, MA
• Providers in East Boston, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.