Individual provider Active NPI

Robert M. Scaccia I, PT

  • Physical Therapist
  • Windham, NH
National Provider Identifier
1225073679
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1736 Issued in NH
Practice address
32 Indian Rock Rd Unit 5
Windham, NH 03087-1697
Phone
(603) 890-8541
Fax
(603) 890-8736
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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 1736 NH Primary

Addresses

Primary practice location

32 Indian Rock Rd Unit 5
Windham, NH 03087-1697

Mailing address

32 Indian Rock Rd Unit 5
Windham, NH 03087-1697
Phone (603) 890-8541

Other practice location 1

1595 Bridge St Unit 5
Dracut, MA 01826-2696
Phone (978) 735-4479

Other practice location 2

132 E Broadway
Derry, NH 03038-1822
Phone (603) 421-2810

Other identifiers 1

IdentifierTypeStateIssuer
30391625MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisad@scacciapt.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060110000102 NH Practitioner - Physical Therapist in Private Practice 4789607334 Reassigns benefits to 1 organization
I20060814000187 MA Practitioner - Physical Therapist in Private Practice 4789607334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Massachusetts Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scaccia Physical Therapy and Sports Conditioning, LLCGroup PAC ID 9133282312, 7 clinicians

Practice addresses (Care Compare)

1595 Bridge St
Unit 5
Dracut, MA 01826-2696
Phone (978) 735-4479

32 Indian Rock Rd
Windham, NH 03087-1697
Phone (603) 890-8541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1736NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Scaccia Physical Therapy & Sports Conditioning, LLC Physical Therapist CurrentSince May 4, 1999 Accepting new patients
Summit Physical Therapy & Rehabilitation Services, Inc. Physical Therapist PastSince Jul 24, 2022 Accepting new patients
Functional Chiropractic, Inc. PastSince Jan 1, 2009 Accepting new patients

Locations

60 Rockingham Rd
Unit 2
Windham, NH 03087
Phone (603) 818-6256

32 Indian Rock Rd
Unit 5
Windham, NH 03087
Phone (603) 890-8541

Organizations & group practices 3

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1225073679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 INDIAN ROCK RD UNIT 5",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871697",
            "telephone_number": "603-890-8541",
            "fax_number": "603-890-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 INDIAN ROCK RD UNIT 5",
            "city": "WINDHAM",
            "state": "NH",
            "postal_code": "030871697",
            "telephone_number": "603-890-8541",
            "fax_number": "603-890-8736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1595 Bridge St Unit 5",
            "address_purpose": "LOCATION",
            "city": "Dracut",
            "state": "MA",
            "postal_code": "018262696",
            "country_code": "US",
            "telephone_number": "978-735-4479",
            "fax_number": "978-735-4490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "132 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381822",
            "country_code": "US",
            "telephone_number": "603-421-2810",
            "fax_number": "603-421-2756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCACCIA",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-06-24",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "1736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30391625",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisad@scacciapt.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "32 Indian Rock Rd Unit 5",
            "city": "Windham",
            "state": "NH",
            "country_code": "US",
            "postal_code": "030871697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Windham, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.