Individual provider Active NPI

Jacqueline Maestas, DPT

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1093436446
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4 Water St
Boston, MA 02109-3503
Phone
(617) 536-1161
NPI assigned
Sep 5, 2022
Last updated
Sep 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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 NU Primary

Addresses

Primary practice location

4 Water St
Boston, MA 02109-3503

Mailing address

103 9TH St Apt 112
Charlestown, MA 02129-4201
Phone (505) 692-0813

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221018001660 MA Practitioner - Physical Therapist in Private Practice 0749656643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Ventures Physical Therapy IncGroup PAC ID 2163474560, 62 clinicians

Practice addresses (Care Compare)

63 Melcher St
BSMT Floor
Boston, MA 02210-1528
Phone (617) 536-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Sep 19, 2022 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Sep 19, 2022 Accepting new patients
Lynore M Martinez MD Professional Association Past Accepting new patients

Locations

10 Liberty Sq
Bsmt 1
Boston, MA 02109

4 Water St
Boston, MA 02109
Phone 61753611613

533 Commonwealth Ave
Ste 1
Boston, MA 02215

Interoperability endpoints

  • Direct secure messaging: jacqueline.maestas.1@2913.direct.athenahealth.com

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, 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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1093436446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 9TH ST APT 112",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021294201",
            "telephone_number": "505-692-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WATER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093503",
            "telephone_number": "617-536-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESTAS",
        "first_name": "JACQUELINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "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 Sep 5, 2022; 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.