Active NPI
Susan M Lattanzi, PT
- Physical Therapist
- Watertown, MA
National Provider Identifier
1265522775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2828
- Practice address
- 521 Mount Auburn St
Suite 205
Watertown, MA 02472-4191 - Phone
- (617) 923-0757
- Fax
- (617) 923-2127
- NPI assigned
- Oct 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2828 | MA | Primary |
Addresses
Primary practice location
521 Mount Auburn St
Suite 205
Watertown, MA 02472-4191
Mailing address
531 Mount Auburn St
Watertown, MA 02472-4150
Phone (617) 923-0757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y65168 | Other | MA | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2828 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265522775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "531 MOUNT AUBURN ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724150",
"telephone_number": "617-923-0757",
"fax_number": "617-923-2127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 MOUNT AUBURN ST",
"address_2": "SUITE 205",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724191",
"telephone_number": "617-923-0757",
"fax_number": "617-923-2127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATTANZI",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "2828",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "Y65168",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.