NPIMap

Organization Active NPI

Back on Track, P.C.

  • Occupational Therapist
  • Brookline, MA
National Provider Identifier
1255484168
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
38 Issued in MA
Legal business name
BACK ON TRACK, P.C.
Practice address
1269 Beacon St
2ND Floor
Brookline, MA 02446-5248
Phone
(617) 730-5337
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Authorized official

Name
Mr. Henry Sisun, PT
Title
President Owner
Phone
(617) 730-5337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 38 MA Primary

Addresses

Primary practice location

1269 Beacon St
2ND Floor
Brookline, MA 02446-5248

Mailing address

721 Reservoir Ave
Cranston, RI 02910-4430
Phone (617) 730-5337

Other identifiers 3

IdentifierTypeStateIssuer
OG0001OtherMABC LEGACY OT SERVICES
Y65633OtherMABC LEGACY PT SERVICES
605716OtherMAHPHC LEGACY

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

186 Great Rd
Bedford, MA 01730
Phone (781) 275-8400

1269 Beacon St
Fl 2
Brookline, MA 02446
Phone (617) 739-2518

1180 Beacon St
Ste C
Brookline, MA 02446
Phone (617) 202-9222

1269 Beacon St
Brookline, MA 02446
Phone (617) 232-1303

1269 Beacon St
#2
Brookline, MA 02446

50 Ferncroft Rd
Danvers, MA 01923
Phone (978) 381-3050

475 Bedford St
Lexington, MA 02420
Phone (781) 862-3727

135 Wells Ave
Newton, MA 02459
Phone (617) 928-1511

249 Lexington St
Waltham, MA 02452

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1255484168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104430",
            "telephone_number": "617-730-5337",
            "fax_number": "617-730-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1269 BEACON ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465248",
            "telephone_number": "617-730-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK ON TRACK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "SISUN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "617-730-5337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "38",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC LEGACY OT SERVICES",
            "identifier": "OG0001",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC  LEGACY PT SERVICES",
            "identifier": "Y65633",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC LEGACY",
            "identifier": "605716",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.