Individual provider Active NPI

Lindsey A Van Den Dungen, DPT

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1275966012
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20828 Issued in MA
Practice address
811 Massachusetts Ave
Boston, MA 02118-2605
Phone
(888) 697-8123
Fax
(888) 329-8678
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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 PT38630 FL
Physical Therapist 225100000X 20828 MA Primary

Addresses

Primary practice location

811 Massachusetts Ave
Boston, MA 02118-2605

Mailing address

811 Massachusetts Ave
Boston, MA 02118-2605
Phone (888) 697-8123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140723002291 MA Practitioner - Physical Therapist in Private Practice 7214153477 Reassigns benefits to 2 organizations
I20240404001754 NY Practitioner - Physical Therapist in Private Practice 7214153477

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
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

33 Electric Ave
Fitchburg, MA 01420-7954
Phone (978) 353-0030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT38630FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist CurrentSince May 20, 2014 Accepting new patients
Forme Physical Therapy, LLC Physical Therapist Current Accepting new patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist Past Accepting new patients
Xrhealth USA Inc PastSince Jul 16, 2023 Accepting new patients

Locations

25 Braintree Hill Park
Ofc P
Braintree, MA 02184
Phone (781) 444-1614

15 Oak St
Ste 1
Needham, MA 02492
Phone (781) 444-1614

Organizations & group practices 5

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": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1275966012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 MASSACHUSETTS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182605",
            "telephone_number": "888-697-8123",
            "fax_number": "888-329-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 MASSACHUSETTS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182605",
            "telephone_number": "888-697-8123",
            "fax_number": "888-329-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN DUNGEN",
        "first_name": "LINDSEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38630",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.