Active NPI
Andrea Boltwood, BA, LMT
- Massage Therapist
- Greenlawn, NY
National Provider Identifier
1124676051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 030121-1
- Practice address
- 8 Burbank CT
Greenlawn, NY 11740-2106 - Phone
- (631) 759-0072
- NPI assigned
- Sep 4, 2019
- Last updated
- Sep 4, 2019
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 030121-1 | NY | Primary |
Addresses
Primary practice location
8 Burbank CT
Greenlawn, NY 11740-2106
Mailing address
8 Burbank CT
Greenlawn, NY 11740-2106
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)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030121-1 | NY | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amb LMT PC | Massage Therapist | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Massage Therapist
- Saint James, NY
- NPI 1538018197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1124676051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 BURBANK CT",
"city": "GREENLAWN",
"state": "NY",
"postal_code": "117402106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 BURBANK CT",
"city": "GREENLAWN",
"state": "NY",
"postal_code": "117402106",
"telephone_number": "631-759-0072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTWOOD",
"first_name": "ANDREA",
"credential": "BA, LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "030121-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenlawn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.