Individual provider Active NPI

Jessica Smith, PT, DPT

  • Physical Therapist
  • Pembroke, MA
National Provider Identifier
1285396630
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25830 Issued in MA
Practice address
340 Oak St
Pembroke, MA 02359-1956
Phone
(781) 829-3500
Fax
(781) 924-5110
NPI assigned
Oct 12, 2021
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 25830 MA Primary

Addresses

Primary practice location

340 Oak St
Pembroke, MA 02359-1956

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211018002108 MA Practitioner - Physical Therapist in Private Practice 9133527401 Reassigns benefits to 1 organization
I20251224001864 IL Practitioner - Physical Therapist in Private Practice 9133527401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MMF Physical Therapy LLCGroup PAC ID 1052790508, 4 clinicians

Practice addresses (Care Compare)

1030 W N Ave
Suite 307
Chicago, IL 60642-2500
Phone (815) 243-2118

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MMF Physical Therapy LLC Physical Therapist CurrentSince Oct 1, 2025 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince May 2, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince May 2, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1030 W North Ave
Ste 307
Chicago, IL 60642
Phone (773) 312-4188

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

197 Massachusetts Ave
Boston, MA 02115
Phone (617) 399-7330

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1285396630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 OAK ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591956",
            "telephone_number": "781-829-3500",
            "fax_number": "781-924-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.