NPIMap

Organization Active NPI

Plymouth Bay Orthopedic Associates, Inc.

  • Orthopedic Physical Therapist
  • Plymouth, MA
National Provider Identifier
1104035302
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
259 Issued in MA
Legal business name
PLYMOUTH BAY ORTHOPEDIC ASSOCIATES, INC.
Practice address
41 Resnik Rd
Plymouth, MA 02360-4842
Phone
(781) 934-7292
Fax
(508) 746-3930
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Dr. R Scott Oliver, MDNPI 1235245135
Title
Owner
Phone
(781) 934-7292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X 259 MA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 259 MA

Addresses

Primary practice location

41 Resnik Rd
Plymouth, MA 02360-4842

Mailing address

95 Tremont St
Suite 1
Duxbury, MA 02332-4738
Phone (781) 934-7292

Other identifiers 1

IdentifierTypeStateIssuer
9764984MedicaidMA

Other names 1

  • PLYMOUTH BAY ORTHOPEDIC & SPORTS THERAPY Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930053629 MA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 3375448335 Practice locations: Plymouth, MA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Plymouth Bay Ortho Spor5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1104035302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 TREMONT ST",
            "address_2": "SUITE 1",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324738",
            "telephone_number": "781-934-7292",
            "fax_number": "781-934-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 RESNIK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604842",
            "telephone_number": "781-934-7292",
            "fax_number": "508-746-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH BAY ORTHOPEDIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "R SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-934-7292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "259",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "259",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9764984",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLYMOUTH BAY ORTHOPEDIC & SPORTS THERAPY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PLYMOUTH BAY ORTHOPEDIC & SPORTS THERAPY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.