Stacy Pineda, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

21968 Issued in MA

Practice address

255 Grapevine Rd
Wenham, MA 01984-1813

Phone

(978) 867-4095

NPI assigned

Jul 8, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gordon CollegeGroup PAC ID 6800955600, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gordon College

  • Physical Therapist
  • Wenham, MA
  • NPI 1831375278

  MA, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1154550481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 GRAPEVINE RD",
            "city": "WENHAM",
            "state": "MA",
            "postal_code": "019841813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 GRAPEVINE RD",
            "city": "WENHAM",
            "state": "MA",
            "postal_code": "019841813",
            "telephone_number": "978-867-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "STACY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21968",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Shore Assessment, Inc.
• North Shore Psychological Services, PC
• Patrick Pang
• Julie A Patterson, COTA/L
• Leigh Perreault, M.ED., ED.S.
• Alyson Preston, RN
• Emily Aw Righter
• Melissa Anne Rossetta, BSN,MS, AGNP-C, CWCN
• Rachel Ryder
• Javier Ricrado Salcido Negrete

• All providers in Wenham, MA
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.