NPIMap

Organization Active NPI

Boston Regional Physical Therapy

  • Physical Therapist
  • Mattapan, MA
National Provider Identifier
1033342316
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
59 Issued in MA
Legal business name
BOSTON REGIONAL PHYSICAL THERAPY
Practice address
1659 Blue Hill Ave
2ND Floor
Mattapan, MA 02126-2107
Phone
(617) 296-9600
NPI assigned
Sep 2, 2009
Last updated
Sep 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Thomas Fiese, PTNPI 1720267438
Title
Owner/PT
Phone
(617) 296-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 59 MA Primary

Addresses

Primary practice location

1659 Blue Hill Ave
2ND Floor
Mattapan, MA 02126-2107

Mailing address

1659 Blue Hill Ave
2ND Floor
Mattapan, MA 02126-2107
Phone (617) 296-9600

Other identifiers 1

IdentifierTypeStateIssuer
FI Y69545MedicaidMA

National Provider Directory

National Provider Directory

Locations

1659 Blue Hill Ave
#2
Mattapan, MA 02126
Phone (617) 296-9600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1033342316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 BLUE HILL AVE",
            "address_2": "2ND FLOOR",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262107",
            "telephone_number": "617-296-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 BLUE HILL AVE",
            "address_2": "2ND FLOOR",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262107",
            "telephone_number": "617-296-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON REGIONAL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "FIESE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "617-296-9600",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "59",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FI Y69545",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.