Individual provider Active NPI

Michael Severo, PT

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1275784381
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
431 Issued in MA
Practice address
300 Tradecenter
Suite 1650
Woburn, MA 01801-1883
Phone
(781) 935-2655
Fax
(781) 935-9097
NPI assigned
Oct 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0008306 CT
Physical Therapist 225100000X 431 MA Primary

Addresses

Primary practice location

300 Tradecenter
Suite 1650
Woburn, MA 01801-1883

Mailing address

210 Commerce Way
Suite 120
Portsmouth, NH 03801-8200
Phone (207) 439-2675

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

LicenseStateTypeSpecialty
11420MAMDPsychologist
0008306CTMDPhysical Therapist
431MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stratham Physical Therapy Physical Therapist Past Accepting new patients

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1275784381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COMMERCE WAY",
            "address_2": "SUITE 120",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038018200",
            "telephone_number": "207-439-2675",
            "fax_number": "207-439-4965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TRADECENTER",
            "address_2": "SUITE 1650",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011883",
            "telephone_number": "781-935-2655",
            "fax_number": "781-935-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERO",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "0008306",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.