Individual provider Active NPI

Michael Joseph Stare, DPT, CSCS

  • Orthopedic Physical Therapist
  • Beverly, MA
National Provider Identifier
1083696579
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
15505 Issued in MA
Practice address
100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6115
Phone
(978) 927-0907
Fax
(978) 927-0537
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 15505 MA Primary

Addresses

Primary practice location

100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6115

Mailing address

6 Corliss Rd
Windham, NH 03087-2388
Phone (603) 918-6080

Other identifiers 1

IdentifierTypeStateIssuer
0316326MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060411000123 MA Practitioner - Physical Therapist in Private Practice 9830108471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6129
Phone (978) 927-0907

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
95.5
Improvement activities
40
Cost
75.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington Physical Therapy, PC Dba Orthopaedics Plus CurrentSince Jan 1, 2008 Accepting new patients
Burlington Physical Therapy, PC, Dba Orthopaedics Plus Orthopedic CurrentSince Jan 1, 2008 Accepting new patients

Locations

54 Middlesex Tpke
Ste 101L
Bedford, MA 01730
Phone (781) 229-8011

100 Cummings Ctr
Ste 121Q
Beverly, MA 01915
Phone (978) 927-0907

101 Cambridge St
Burlington, MA 01803
Phone (781) 229-8011

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1083696579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CORLISS RD",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030872388",
            "telephone_number": "603-918-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 121Q",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-927-0907",
            "fax_number": "978-927-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "15505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0316326",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.