Active NPI
Caitlin Dibiasie, PT
- Physical Therapist
- Concord, MA
National Provider Identifier
1104174028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 20093
- Practice address
- 290 Baker Ave Ste N111
Concord, MA 01742-2190 - Phone
- (978) 369-0730
- NPI assigned
- Aug 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 20093 | MA | Primary |
Addresses
Primary practice location
290 Baker Ave Ste N111
Concord, MA 01742-2190
Mailing address
290 Baker Ave Ste N111
Concord, MA 01742-2190
Phone (978) 369-0730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20093 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beantown Physio, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Brookline, MA
- NPI 1477547529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1104174028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 BAKER AVE STE N111",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422190",
"telephone_number": "978-369-0730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 BAKER AVE STE N111",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422190",
"telephone_number": "978-369-0730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBIASIE",
"first_name": "CAITLIN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-27",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "20093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.