Active NPI
John Wayne Inacio, P.T., A.T.C.
- Physical Therapist
- Natick, MA
National Provider Identifier
1205837036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4097
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y65359 | Other | MA | MASSACHUSETTS BLUE CROSS BLUE SHIELD |
| 469186 | Other | MA | TUFTS |
| 0370797 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4097 | MA | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middlesex Rehabilitation, LLC | Physical Therapist | Current | 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.
-
- Physical Therapy Clinic/Center
- Hudson, MA
- NPI 1124625298
Physical Therapist
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.