Organization Active NPI

Sports Medicine & Rehabilitation Therapy Inc

  • Physical Therapist
  • Reading, MA
National Provider Identifier
1073590303
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE & REHABILITATION THERAPY INC
Practice address
328 Main St
Reading, MA 01867
Phone
(781) 944-5246
Fax
(781) 944-6686
NPI assigned
Dec 28, 2005
Last updated
Sep 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Dennis Ponte
Title
Clinic Owner
Phone
(781) 944-5246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

328 Main St
Reading, MA 01867

Mailing address

328 Main St
Reading, MA 01867
Phone (781) 944-5246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051103000022 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618995291 Receives reassigned benefits from 6 practitioners
Practice locations: Malden, MA; Reading, MA

National Provider Directory

National Provider Directory

Locations

300 Commercial St
Ste 29
Malden, MA 02148
Phone (617) 324-0310

42 Sharon St
Malden, MA 02148
Phone (781) 324-0310

328 Main St
Reading, MA 01867
Phone (781) 324-0310

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1073590303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 MAIN ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "01867",
            "telephone_number": "781-944-5246",
            "fax_number": "781-944-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 MAIN ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "01867",
            "telephone_number": "781-944-5246",
            "fax_number": "781-944-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE & REHABILITATION THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "PONTE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "781-944-5246"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.