Individual provider Active NPI

Emma Winslow Thacher

  • Physical Therapist
  • Wellesley, MA
National Provider Identifier
1134090376
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL88757 Issued in MA
Practice address
204 Worcester St
Wellesley, MA 02481-5473
Phone
(781) 772-2406
Fax
(844) 912-8608
NPI assigned
Sep 12, 2025
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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 PTL88757 MA Primary

Addresses

Primary practice location

204 Worcester St
Wellesley, MA 02481-5473

Mailing address

4 Richmond SQ
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923004541 MA Practitioner - Physical Therapist in Private Practice 7911402748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians
Joint Ventures Physical Therapy IncGroup PAC ID 2163474560, 62 clinicians

Practice addresses (Care Compare)

115 Norwood Park S
Norwood, MA 02062-4633
Phone (781) 702-4630

204 Worcester St
Suite 200
Wellesley, MA 02481-5420
Phone (617) 536-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL88757MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Sep 15, 2025 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

1395 Commerce Way
Ste 112
Attleboro, MA 02703
Phone (508) 455-5740

115 Norwood Park S
Norwood, MA 02062
Phone (781) 349-5181

204 Worcester St
#200
Wellesley, MA 02481

204 Worcester St
Wellesley Hls, MA 02481
Phone (617) 566-0062

4 Richmond Sq
Providence, RI 02906
Phone (401) 885-2821

4 Richmond Sq
Ste 200
Providence, RI 02906

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1134090376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815473",
            "telephone_number": "781-772-2406",
            "fax_number": "844-912-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACHER",
        "first_name": "EMMA",
        "middle_name": "WINSLOW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL88757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.