Individual provider Active NPI

Melissa Buitkus, PT, DPT

  • Physical Therapist
  • Danvers, MA
National Provider Identifier
1104474691
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24426 Issued in MA
Practice address
156 Andover St Unit 2
Danvers, MA 01923-1468
Phone
(978) 767-8343
Fax
(978) 208-0758
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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 24426 MA Primary

Addresses

Primary practice location

156 Andover St Unit 2
Danvers, MA 01923-1468

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923000859 MA Practitioner - Physical Therapist in Private Practice 2163752924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

87 Pleasant Valley St
FL 2
Methuen, MA 01844-7202
Phone (978) 965-6002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24426MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc CurrentSince Aug 4, 2019 Accepting new patients

Locations

156 Andover St
Unit 2
Danvers, MA 01923
Phone (978) 767-8343

35 Ymca Dr
Lowell, MA 01852
Phone (781) 679-2003

87 Pleasant Valley St
Fl 2
Methuen, MA 01844
Phone (978) 965-6002

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

1 Credit Union Way
Fl 3
Randolph, MA 02368
Phone 7819613370225

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

Organizations & group practices 2

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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1104474691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 ANDOVER ST UNIT 2",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231468",
            "telephone_number": "978-767-8343",
            "fax_number": "978-208-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUITKUS",
        "first_name": "MELISSA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.