Active NPI
Kathryn Blumberg, MSPT
- Physical Therapist
- Newton, MA
National Provider Identifier
1174660294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6768
- Practice address
- 31A Jackson Street
Newton, MA 02459 - Phone
- (617) 916-2653
- Fax
- (617) 507-6415
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6768 | MA | Primary |
Addresses
Primary practice location
31A Jackson Street
Newton, MA 02459
Mailing address
110 Jackson St
Newton, MA 02459-2538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060411000328 | MA | Practitioner - Physical Therapist in Private Practice | 9234148792 | Practice locations: Newton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Boston University School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
110 Jackson St
Newton, MA 02459-2538
Phone (617) 916-2653
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6768 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174660294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 JACKSON ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024592538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31A JACKSON STREET",
"city": "NEWTON",
"state": "MA",
"postal_code": "02459",
"telephone_number": "617-916-2653",
"fax_number": "617-507-6415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMBERG",
"first_name": "KATHRYN",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "6768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.