Individual provider Active NPI

Susie Deana, PT

  • Physical Therapist
  • Amesbury, MA
National Provider Identifier
1174514947
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15138 Issued in MA
Practice address
110 Haverhill Rd
Amesbury, MA 01913-2123
Phone
(978) 388-4500
Fax
(978) 834-7229
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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 15138 MA Primary

Addresses

Primary practice location

110 Haverhill Rd
Amesbury, MA 01913-2123

Mailing address

110 Haverhill Rd
Amesbury, MA 01913-2123
Phone (978) 388-4500

Other names 1

  • Susie Fligor Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000085 MA Practitioner - Physical Therapist in Private Practice 5193742542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mansfield Physical Therapy and Wellness LLCGroup PAC ID 4082976832, 8 clinicians

Practice addresses (Care Compare)

200 Chauncy St
Suite 104
Mansfield, MA 02048-1200
Phone (508) 339-7999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15138MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mansfield Physical Therapy & Wellness LLC Physical Therapist CurrentSince Mar 1, 2018 Accepting new patients
Mass Sport & Spine, Inc. Physical Therapist Past Accepting new patients
Motion Works Physical Therapy, LLC Physical Therapist PastSince Dec 21, 2016 Accepting new patients

Locations

200 Chauncy St
Ste 104
Mansfield, MA 02048
Phone (508) 339-7999

200 Chauncy St
Mansfield, MA 02048
Phone (508) 339-7999

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1174514947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HAVERHILL RD",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019132123",
            "telephone_number": "978-388-4500",
            "fax_number": "978-834-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HAVERHILL RD",
            "city": "AMESBURY",
            "state": "MA",
            "postal_code": "019132123",
            "telephone_number": "978-388-4500",
            "fax_number": "978-834-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANA",
        "first_name": "SUSIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSIE",
            "last_name": "FLIGOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Amesbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.