Individual provider Active NPI

Alexander Adrian

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1073345757
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27838 Issued in MA
Practice address
209 Columbus Ave
Boston, MA 02116-5109
Phone
(617) 247-2300
NPI assigned
Aug 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 27838 MA Primary

Addresses

Primary practice location

209 Columbus Ave
Boston, MA 02116-5109

Mailing address

110 Crosswinds Dr
Groton, CT 06340-4875

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905003408 MA Practitioner - Physical Therapist in Private Practice 9537609508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Connecticut School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Sports Injury Center, P.C.Group PAC ID 4880655505, 4 clinicians

Practice addresses (Care Compare)

209 Columbus Ave
Lowr Level
Boston, MA 02116-5109
Phone (617) 247-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27838MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spine & Sports Injury Center, P.C. CurrentSince Aug 13, 2023 Accepting new patients
Spine & Sports Injury Center, P.C. Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients

Locations

209 Columbus Ave
Boston, MA 02116
Phone (617) 247-2300

4 Avery St
Boston, MA 02111
Phone (617) 247-2300

209 Columbus Ave
Lowr
Boston, MA 02116
Phone (617) 247-2300

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": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1073345757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CROSSWINDS DR",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 COLUMBUS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165109",
            "telephone_number": "617-247-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADRIAN",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.