Jeremy Lichtman, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24886 Issued in MA

Practice address

26 S Main St
Randolph, MA 02368-4821

Phone

(781) 961-9200

Fax

(781) 961-6599

NPI assigned

Jun 3, 2020

Sex

Male

Sole proprietor

Yes

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment Care Compare group
• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Brockton, MA
  • NPI 1740390459
  NPD
• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Franklin, MA
  • NPI 1821108549
  NPD

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1073137287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684821",
            "telephone_number": "781-961-9200",
            "fax_number": "781-961-6599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Revere",
            "state": "MA",
            "postal_code": "021513675",
            "country_code": "US",
            "telephone_number": "781-485-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTMAN",
        "first_name": "JEREMY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank John Leone Jr.
• Grace Leung, PHARMD
• Lizandre Lamour Levarity, M.ED
• Tracie Levene
• Tresca T Liburd
• Lifeseed Doula Care, LLC
• Yung Lin, DMD
• Dylan Patrick Little
• Jing Liu
• Princess Lloyd

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.