Amanda Lynn Tetreault, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17393 Issued in MA

Practice address

1101 Beacon St
Ste 5E
Brookline, MA 02446-5587

Phone

(617) 232-6633

Fax

(617) 232-6832

NPI assigned

Feb 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Performance Rehabilitation of Western New England LLC

  dba ATI Physical Therapy of Western Massachusetts

  • Physical Therapist
  • West Springfield, MA
  • NPI 1710919063
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1255306668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 BEACON ST",
            "address_2": "#1",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452030",
            "telephone_number": "617-974-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST",
            "address_2": "STE 5E",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-232-6633",
            "fax_number": "617-232-6832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETREAULT",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry V Temple, D.M.D.
• Samuel Tencer, DMD
• Rachel Tenenbein, MD
• Pamela Ann Terreri, APRNBC
• Kerri Ann Tester, LICSW
• Shannon Erika Tevenan, PT, DPT
• Sangnya Thaker, PHARMD
• Prachi Thakor, DPT
• The Balance Place LLC
• The Brookline Community Mental Health Center

• Physical Therapist in Brookline, MA
• Providers in Brookline, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.