Active NPI
Andrew Nicholas Pacheco, PT, DPT
- Physical Therapist
- Jamaica Plain, MA
National Provider Identifier
1275236929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL26696
- Practice address
- 804 Centre St Apt 205
Jamaica Plain, MA 02130-2716 - Phone
- (909) 532-9195
- NPI assigned
- Mar 22, 2023
- Sex
- Male
- 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 | PTL26696 | MA | Primary |
Addresses
Primary practice location
804 Centre St Apt 205
Jamaica Plain, MA 02130-2716
Mailing address
804 Centre St Apt 205
Jamaica Plain, MA 02130-2716
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL26696 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1275236929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 CENTRE ST APT 205",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 CENTRE ST APT 205",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302716",
"telephone_number": "909-532-9195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "ANDREW",
"middle_name": "NICHOLAS",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-22",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "PTL26696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.