Individual provider Active NPI

Jason Lundmark, DPT

  • Physical Therapist
  • Cohasset, MA
National Provider Identifier
1063901569
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22980 Issued in MA
Practice address
231 Chief Justice Cushing Hwy Ste 203
Cohasset, MA 02025-1383
Phone
(781) 214-8585
NPI assigned
May 9, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 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 22980 MA Primary

Addresses

Primary practice location

231 Chief Justice Cushing Hwy Ste 203
Cohasset, MA 02025-1383

Mailing address

264 Brook Cir
Hanover, MA 02339-1877
Phone (716) 969-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22980MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Cod Healthcare, Inc Past Accepting new patients

Organizations & group practices 1

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1063901569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 BROOK CIR",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391877",
            "telephone_number": "716-969-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 CHIEF JUSTICE CUSHING HWY STE 203",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "020251383",
            "telephone_number": "781-214-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDMARK",
        "first_name": "JASON",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2022-05-03",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohasset, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.