Individual provider Active NPI

Mark Lembo, PT

  • Physical Therapist
  • Pembroke, MA
National Provider Identifier
1023137577
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10914 Issued in MA
Practice address
300 Oak St
Suite 450
Pembroke, MA 02359-1984
Phone
(781) 829-9966
Fax
(781) 829-2164
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 10914 MA Primary

Addresses

Primary practice location

300 Oak St
Suite 450
Pembroke, MA 02359-1984

Mailing address

300 Oak St
Suite 450
Pembroke, MA 02359-1984
Phone (781) 829-9966

Other identifiers 4

IdentifierTypeStateIssuer
Y67514OtherMABLUE CROSS BLUE SHIELD
468731OtherMATUFTS
0030198OtherMANEIGHBORHOOD HEALTH PLAN
3279637OtherMAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000761 MA Practitioner - Physical Therapist in Private Practice 4880640051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Rehab Associates PCGroup PAC ID 8820044092, 3 clinicians

Practice addresses (Care Compare)

300 Oak St
Suite 450
Pembroke, MA 02359-1960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Sports & Muscular Physical Therapist PastSince Nov 9, 2015 Accepting new patients

Organizations & group practices 2

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023137577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OAK ST",
            "address_2": "SUITE 450",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591984",
            "telephone_number": "781-829-9966",
            "fax_number": "781-829-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OAK ST",
            "address_2": "SUITE 450",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591984",
            "telephone_number": "781-829-9966",
            "fax_number": "781-829-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMBO",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "10914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y67514",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "468731",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0030198",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3279637",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.