Individual provider Active NPI

Lawrence Ross, RPT

  • Orthopedic Physical Therapist
  • Wellesley, MA
National Provider Identifier
1073536868
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
002762 Issued in CT
Practice address
2 Laurel Ave
Wellesley, MA 02481-7523
Phone
(781) 237-5585
Fax
(781) 237-5633
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MA
Orthopedic Physical Therapist 2251X0800X 002762 CT Primary

Addresses

Primary practice location

2 Laurel Ave
Wellesley, MA 02481-7523

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

4747 Main St
Bridgeport, CT 06606-1804
Phone (203) 372-0649

Other practice location 2

153 East Ave
Suite 30-31
Norwalk, CT 06851
Phone (203) 853-1073

Other practice location 3

2900 Main St
Stratford, CT 06614-4946
Phone (203) 372-0649

Other identifiers 5

IdentifierTypeStateIssuer
18901OtherCTCIGNA/ORTHONET ID NUMBER
ANC1685OtherCTOXFORD ID NUMBER
50RPTINC0CT01OtherCTBLUE CROSS BLUE SHIELD NU
764202OtherCTCONNECTICARE ID NUMBER
2019893OtherCTAETNA ID NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124000961 MA Practitioner - Physical Therapist in Private Practice 9931199395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians

Practice addresses (Care Compare)

2 Laurel Ave
Wellesley, MA 02481-7523
Phone (781) 237-5585

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002762CTMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 26, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Dec 26, 2023 Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

1016 Paradise Rd
Swampscott, MA 01907
Phone (781) 309-9007

2 Laurel Ave
Wellesley Hills, MA 02481
Phone (781) 237-5585

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1073536868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LAUREL AVE",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024817523",
            "telephone_number": "781-237-5585",
            "fax_number": "781-237-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4747 Main St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066061804",
            "country_code": "US",
            "telephone_number": "203-372-0649",
            "fax_number": "203-373-0376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 East Ave",
            "address_2": "Suite 30-31",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "06851",
            "country_code": "US",
            "telephone_number": "203-853-1073",
            "fax_number": "203-853-0699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 Main St",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "CT",
            "postal_code": "066144946",
            "country_code": "US",
            "telephone_number": "203-372-0649",
            "fax_number": "203-373-0376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-01-09",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CT",
            "license": "002762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/ORTHONET ID NUMBER",
            "identifier": "18901",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD ID NUMBER",
            "identifier": "ANC1685",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NU",
            "identifier": "50RPTINC0CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE ID NUMBER",
            "identifier": "764202",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID NUMBER",
            "identifier": "2019893",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.