Raegan N Moulton, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

50 Gold Star Blvd
Worcester, MA 01606-2812

Phone

(508) 856-9510

Fax

(508) 853-1907

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Reliant Medical Group, Inc

  • Physical Therapist
  • Worcester, MA
  • NPI 1295827962
  Medicare reassignment Care Compare group NPD
• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  NPD

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1033890686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062812",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062812",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 New Lancaster Rd",
            "address_purpose": "LOCATION",
            "city": "Leominster",
            "state": "MA",
            "postal_code": "014534958",
            "country_code": "US",
            "telephone_number": "978-840-1900",
            "fax_number": "978-840-1263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "RAEGAN",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iman Moula, MD
• Tara T. Mould, M.D.
• Ian Matthew Moulton
• Jennifer Moulton, PT
• Kristen Leigh Moulton, DO
• Maria Izabel Moura-Westdijk
• Dalton T Mourao, MD
• Laura Whittington Mouro, CRNA
• Demian G Mousad, M.D
• Scott Mousette

• Physical Therapist in Worcester, MA
• Providers in Worcester, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.