Active NPI
Jackson Roskamp Smith, DPT
- Orthopedic Physical Therapist
- Boston, MA
National Provider Identifier
1114703964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 133 Brookline Ave
Boston, MA 02215-3904 - Phone
- (617) 421-1347
- NPI assigned
- Sep 7, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | MA | Primary |
Addresses
Primary practice location
133 Brookline Ave
Boston, MA 02215-3904
Mailing address
16 Butterfield Dr
Westborough, MA 01581-3946
Phone (508) 494-9146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrius Health, Inc. | Orthopedic | Current | Accepting new patients |
| Atrius Health, Inc. | Current | Accepting new patients | |
| Atrius Health, Inc. | Orthopedic | Current | Accepting new patients |
Locations
147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051
133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000
Interoperability endpoints
- jsmithpt373453@direct.atrius.masshiway.net
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.
-
- Internal Medicine Physician
- Watertown, MA
- NPI 1043366537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1114703964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 BUTTERFIELD DR",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "015813946",
"telephone_number": "508-494-9146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 BROOKLINE AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "022153904",
"telephone_number": "617-421-1347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JACKSON",
"middle_name": "ROSKAMP",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.