Individual provider Active NPI

John Wayne Inacio, P.T., A.T.C.

  • Physical Therapist
  • Natick, MA
National Provider Identifier
1205837036
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4097 Issued in MA
Practice address
214 N Main St
Suite 107
Natick, MA 01760-1131
Phone
(508) 650-1856
Fax
(508) 653-9563
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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 4097 MA Primary

Addresses

Primary practice location

214 N Main St
Suite 107
Natick, MA 01760-1131

Mailing address

23 Liberty St
Natick, MA 01760-1245
Phone (508) 647-2299

Other identifiers 3

IdentifierTypeStateIssuer
Y65359OtherMAMASSACHUSETTS BLUE CROSS BLUE SHIELD
469186OtherMATUFTS
0370797MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4097MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Rehabilitation, LLC Physical Therapist CurrentSince Oct 5, 2020 Accepting new patients

Locations

131 Coolidge St
Ste 222
Hudson, MA 01749
Phone (978) 562-0345

Organizations & group practices 1

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1205837036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LIBERTY ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017601245",
            "telephone_number": "508-647-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N MAIN ST",
            "address_2": "SUITE 107",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017601131",
            "telephone_number": "508-650-1856",
            "fax_number": "508-653-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INACIO",
        "first_name": "JOHN",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "P.T., A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS BLUE CROSS BLUE SHIELD",
            "identifier": "Y65359",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "469186",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0370797",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.