Individual provider Active NPI

Jillian McNabb, DPT

  • Physical Therapist
  • Melrose, MA
National Provider Identifier
1255754081
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20645 Issued in MA
Practice address
2 Washington St
Melrose, MA 02176-6055
Phone
(781) 646-8440
NPI assigned
Jan 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 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 20645 MA Primary

Addresses

Primary practice location

2 Washington St
Melrose, MA 02176-6055

Mailing address

2 Washington St
Melrose, MA 02176-6055

Other identifiers 1

IdentifierTypeStateIssuer
110108641AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006001688 MA Practitioner - Physical Therapist in Private Practice 1658591185 Reassigns benefits to 1 organization

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
Group practices
Massachusetts Medical and Physical Therapy Associates IncGroup PAC ID 3779525837, 23 clinicians

Practice addresses (Care Compare)

500 W Cummings Park
2100 Fitzgerald Physical Therapy Assoc
Woburn, MA 01801-6513
Phone (781) 305-4656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Medical & Physical Therapy Associates Inc. Physical Therapist CurrentSince Apr 17, 2023 Accepting new patients

Locations

500 W Cummings Park
Ste 2100
Woburn, MA 01801
Phone (781) 305-4656

500 W Cummings Park
Ste 21
Woburn, MA 01801
Phone (781) 305-4656

Organizations & group practices 1

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": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1255754081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WASHINGTON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021766055",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WASHINGTON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021766055",
            "telephone_number": "781-646-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "JILLIAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110108641A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.