Individual provider Active NPI

Grace McCormick, DPT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1104427103
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18767 Issued in CO
Practice address
3605 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6630
Phone
(719) 265-6601
Fax
(719) 265-6649
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25278 MA
Physical Therapist 225100000X 18767 CO Primary
Physical Therapist 225100000X 070026586 IL

Addresses

Primary practice location

3605 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6630

Mailing address

3605 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6630
Phone (719) 265-6601

Other practice location 1

362 Belmont St
Brockton, MA 02301-4950
Phone (508) 584-7711

Other practice location 2

1980 2nd St
Highland Park, IL 60035-3116
Phone (847) 681-8720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201110001932 MA Practitioner - Physical Therapist in Private Practice 6204246853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

362 Belmont St
Brockton, MA 02301-4950
Phone (508) 584-6624

Merit-based Incentive Payment System (MIPS)

Final score
96.68 of 100Reported as group
Quality
96.09
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc CurrentSince Nov 3, 2020 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Nov 3, 2020 Accepting new patients

Locations

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

362 Belmont St
Brockton, MA 02301
Phone (508) 584-6622

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

Interoperability endpoints

  • Direct secure messaging: grace.mccormick.p9@direct.athleticoltd.nextgenshare.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1104427103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186630",
            "telephone_number": "719-265-6601",
            "fax_number": "719-265-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186630",
            "telephone_number": "719-265-6601",
            "fax_number": "719-265-6649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "362 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023014950",
            "country_code": "US",
            "telephone_number": "508-584-7711",
            "fax_number": "508-584-7744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1980 2nd St",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "600353116",
            "country_code": "US",
            "telephone_number": "847-681-8720",
            "fax_number": "847-681-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "GRACE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25278",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "18767",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070026586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.