Individual provider Active NPI

Ellen T Poveromo, PT

  • Physical Therapist
  • Beverly, MA
National Provider Identifier
1174514467
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5499 Issued in MA
Practice address
100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6115
Phone
(978) 927-0907
NPI assigned
Nov 4, 2005
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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 5499 MA Primary

Addresses

Primary practice location

100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6115

Mailing address

22 Arlington Ave
Beverly, MA 01915-1002
Phone (978) 927-2528

Other identifiers 1

IdentifierTypeStateIssuer
0395871MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060417000214 MA Practitioner - Physical Therapist in Private Practice 6608885850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Cummings Ctr
Suite 121Q
Beverly, MA 01915-6129
Phone (978) 927-0907

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
95.5
Improvement activities
40
Cost
75.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington Physical Therapy, PC Dba Orthopaedics Plus Physical Therapist CurrentSince Apr 22, 1999 Accepting new patients
Burlington Physical Therapy, PC, Dba Orthopaedics Plus Physical Therapist CurrentSince Apr 22, 1999 Accepting new patients

Locations

54 Middlesex Tpke
Ste 101L
Bedford, MA 01730
Phone (781) 229-8011

100 Cummings Ctr
Ste 121Q
Beverly, MA 01915
Phone (978) 927-0907

100 Cummings Ctr
Ste 106Q
Beverly, MA 01915
Phone (978) 720-8811

101 Cambridge St
Ste 8
Burlington, MA 01803
Phone (781) 229-8011

101 Cambridge St
Burlington, MA 01803
Phone (781) 229-8011

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, 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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1174514467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ARLINGTON AVE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151002",
            "telephone_number": "978-927-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 121Q",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-927-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVEROMO",
        "first_name": "ELLEN",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0395871",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.