Individual provider Active NPI

Ellen Collard, DPT

  • Physical Therapist
  • East Providence, RI
National Provider Identifier
1215368592
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02650
Practice address
1525 Wampanoag Trail
Suite 205
East Providence, RI 02915-1038
Phone
(401) 433-4049
Fax
(401) 433-0612
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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 PT02650 Primary

Addresses

Primary practice location

1525 Wampanoag Trail
Suite 205
East Providence, RI 02915-1038

Mailing address

1525 Wampanoag Trail
Suite 205
East Providence, RI 02915-1038
Phone (401) 433-4049

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022001545 MA Practitioner - Physical Therapist in Private Practice 6002047545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Industry Rd
Unit 3
Marstons Mills, MA 02648-1760

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000

7 Clyde Rd
Somerset, NJ 08873-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
Cape Coastal PT, Inc Physical Therapist CurrentSince Jan 10, 2023 Accepting new patients

Locations

40 Industry Rd
Ste 3
Marstons Mls, MA 02648
Phone (508) 420-0022

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 2

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": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1215368592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 WAMPANOAG TRAIL",
            "address_2": "SUITE 205",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029151038",
            "telephone_number": "401-433-4049",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 WAMPANOAG TRAIL",
            "address_2": "SUITE 205",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029151038",
            "telephone_number": "401-433-4049",
            "fax_number": "401-433-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLARD",
        "first_name": "ELLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "PT02650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.