Individual provider Active NPI

Elizabeth L McKeon, DPT

  • Physical Therapist
  • Hingham, MA
National Provider Identifier
1154924645
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25285 Issued in MA
Practice address
170 Shipyard Dr Unit a
Hingham, MA 02043-1611
Phone
(781) 875-8343
Fax
(781) 795-9929
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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 25285 MA Primary

Addresses

Primary practice location

170 Shipyard Dr Unit a
Hingham, MA 02043-1611

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201127000120 MA Practitioner - Physical Therapist in Private Practice 5890106728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beantown Physio, Inc 7 clinicians

Practice addresses (Care Compare)

33 Pond Ave
107B
Brookline, MA 02445-7163
Phone (617) 232-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25285MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beantown Physio, Inc Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Nov 16, 2020 Accepting new patients

Locations

703 Granite St
Ste 3
Braintree, MA 02184

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

170 Shipyard Dr
Unit A
Hingham, MA 02043
Phone (781) 875-8343

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

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.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1154924645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 SHIPYARD DR UNIT A",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020431611",
            "telephone_number": "781-875-8343",
            "fax_number": "781-795-9929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.