Individual provider Active NPI

Jamie Vetterli

  • Physical Therapist
  • Acton, MA
National Provider Identifier
1245087303
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
340 Great Rd
Acton, MA 01720-4020
Phone
(978) 287-6170
Fax
(978) 287-1476
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 MA Primary

Addresses

Primary practice location

340 Great Rd
Acton, MA 01720-4020

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515004174 MA Practitioner - Physical Therapist in Private Practice 5991146334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians

Practice addresses (Care Compare)

340 Great Rd
Acton, MA 01720-4020
Phone (978) 287-6170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Apr 22, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Apr 22, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist Current Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

340 Great Rd
Acton, MA 01720
Phone (978) 287-6170

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

188 Boston Rd
#B
North Billerica, MA 01862
Phone (978) 901-3513

Organizations & group practices 4

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": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1245087303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204020",
            "telephone_number": "978-287-6170",
            "fax_number": "978-287-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTERLI",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.