NPIMap

Organization Active NPI

Paramount Performance and Rehab Inc

  • Physical Therapy Clinic/Center
  • Newton, MA
National Provider Identifier
1104162205
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PARAMOUNT PERFORMANCE AND REHAB INC
Practice address
244 Needham St
Newton, MA 02464-1595
Phone
(713) 443-5939
NPI assigned
Dec 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Mr. Russell William Childers II, PTNPI 1770815607
Title
President
Phone
(713) 443-5939

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

244 Needham St
Newton, MA 02464-1595

Mailing address

244 Needham St
Newton, MA 02464-1595
Phone (713) 443-5939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130419000162 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577709450 Receives reassigned benefits from 2 practitioners
Practice locations: Newton, MA

National Provider Directory

National Provider Directory

Locations

244 Needham St
Newton Upper Falls, MA 02464
Phone (617) 641-6700

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1104162205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 NEEDHAM ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641595",
            "telephone_number": "713-443-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 NEEDHAM ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641595",
            "telephone_number": "713-443-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAMOUNT PERFORMANCE AND REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-443-5939",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.