Individual provider Active NPI

Jason A Weber, RPT

  • Physical Therapist
  • Charlton, MA
National Provider Identifier
1114907110
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13287 Issued in MA
Practice address
20 Southbridge Rd
Charlton, MA 01507
Phone
(508) 248-4141
Fax
(508) 248-4106
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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 13287 MA Primary

Addresses

Primary practice location

20 Southbridge Rd
Charlton, MA 01507

Mailing address

630 Plantation St
Worcestor, MA 01605
Phone (508) 248-4141

Other identifiers 19

IdentifierTypeStateIssuer
042472266OtherONE HEALTH PLAN
AA4052OtherHARVARD PILGRIM HEALTHCAR
0331660OtherMEDICAID/WELFARE
785967OtherMVP HEALTH CARE
2779432001OtherCIGNA PAL ID (REFERRAL #)
35481155OtherCIGNA HEALTHSOURCE
48327OtherFALLON COMMUNITY HEALTH P
Y67944OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MANAGMEN
042472266OtherPRIVATE HEALTHCARE SYSTEM
2779432OtherCIGNA HEALTH PLAN
Y67944OtherBLUE SHIELD HMO BLUE
Y68672OtherMEDICARE B
0331660OtherMAMEDICAID/WELFARE
0331660MedicaidMA
650019549OtherRAILROAD MEDICARE
042472266OtherTHREE RIVERS
7292628OtherAETNA/US HEALTHCARE
Y67944OtherBLUE SHIELD INDEMNITY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210409001427 MA Practitioner - Physical Therapist in Private Practice 1557779600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

50 Gold Star Blvd
Worcester, MA 01606-2812
Phone (508) 856-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13287MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients
Reliant Medical Group, Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

20 Southbridge Rd
Charlton, MA 01507
Phone (508) 248-4141

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: jason.weber.npi1114907110.reliant@direct.optumcare.masshiway.net

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1114907110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTOR",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-248-4141",
            "fax_number": "508-248-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SOUTHBRIDGE RD",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "01507",
            "telephone_number": "508-248-4141",
            "fax_number": "508-248-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "13287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA4052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID/WELFARE",
            "identifier": "0331660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "785967",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL ID (REFERRAL #)",
            "identifier": "2779432001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "35481155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "48327",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "Y67944",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGMEN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "2779432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "Y67944",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "Y68672",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID/WELFARE",
            "identifier": "0331660",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0331660",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650019549",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "7292628",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "Y67944",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.