Individual provider Active NPI

Lynn Dreyfus

  • Physical Therapist
  • Brookline, MA
National Provider Identifier
1043400500
Registry record updated Sep 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5805 Issued in MA
Practice address
1318 Beacon St Ste 19
Brookline, MA 02446-3793
Phone
(617) 852-3557
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2022

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 5805 MA Primary

Addresses

Primary practice location

1318 Beacon St Ste 19
Brookline, MA 02446-3793

Mailing address

1318 Beacon St Ste 19
Brookline, MA 02446-3793
Phone (176) 852-3557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706000202 MA Practitioner - Physical Therapist in Private Practice 0042612640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5805MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Jun 22, 2021 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Jun 22, 2021 Accepting new patients

Locations

10 Liberty Sq
Bsmt 1
Boston, MA 02109

648 Beacon St
Boston, MA 02215
Phone (617) 353-9345

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662854400000",
    "number": "1043400500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 BEACON ST STE 19",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463793",
            "telephone_number": "176-852-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 BEACON ST STE 19",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463793",
            "telephone_number": "617-852-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYFUS",
        "first_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-09-11",
        "certification_date": "2022-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; 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.