Active NPI
Reform Physical Therapy LLC.
- Physical Therapy Clinic/Center
- Natick, MA
National Provider Identifier
1205548880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- REFORM PHYSICAL THERAPY LLC.
- Practice address
- 4 Wethersfield Rd # 8
Natick, MA 01760-1770 - Phone
- (508) 653-6000
- NPI assigned
- Dec 15, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan Kim, PT, DPT
- Title
- Owner/Physical Therapist
- Phone
- (617) 564-2422
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
4 Wethersfield Rd # 8
Natick, MA 01760-1770
Mailing address
4 Wethersfield Rd # 8
Natick, MA 01760-1770
Other names 1
- Preservation Physical THerapy and Wellness
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230130002070 | MA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 8123499175 |
Receives reassigned benefits from 4 practitioners Practice locations: Natick, MA |
National Provider Directory
National Provider DirectoryLocations
4 Wethersfield Rd
#8
Natick, MA 01760
Phone (508) 653-6000
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Natick, MA
- NPI 1164099917
-
- Hand Occupational Therapist
- Natick, MA
- NPI 1710511381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671062400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671062400000",
"number": "1205548880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 WETHERSFIELD RD # 8",
"city": "NATICK",
"state": "MA",
"postal_code": "017601770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 WETHERSFIELD RD # 8",
"city": "NATICK",
"state": "MA",
"postal_code": "017601770",
"telephone_number": "508-653-6000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REFORM PHYSICAL THERAPY LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2022-12-15",
"last_updated": "2022-12-15",
"certification_date": "2022-12-15",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
"authorized_official_telephone_number": "617-564-2422",
"authorized_official_credential": "PT, DPT"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Preservation Physical THerapy and Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Natick, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.