Christine R Dooley, PT – Physical Therapist

Key facts

NPI: 1295715670
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 4697 (MA)
Practice address: 50 Gold Star Blvd
Worcester, MA 01606
Phone: (508) 856-9510
Fax: (508) 853-1907
NPI assigned: Jan 20, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Reliant Medical Group, Inc Physical Therapist · Worcester, MA · NPI 1295827962

Medicare reassignment Care Compare group NPD MA · PHYSICAL THERAPIST
Reliant Medical Group, Inc Family Medicine Physician · Worcester, MA · NPI 1720017528

Care Compare group NPD

Medicare Care Compare profile

Specialty: Physical Therapist in Private Practice
Education: Other, 1982
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Reliant Medical Group Inc (638 clinicians)

Practice addresses (Care Compare)

50 Gold Star Blvd
Worcester, MA 01606-2812
Phone (508) 856-9510

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20061212000470	MA	Practitioner - Physical Therapist in Private Practice	2668471020	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
4697	MA	MD	Clinical Psychologist

Practice roles

Organization	Specialty	Status	New patients
Reliant Medical Group, Inc		Current since Jan 17, 2000	Accepting new patients
Reliant Medical Group, Inc	Physical Therapist	Current since Jan 17, 2000	Accepting new patients

Locations

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

5 Neponset St
Fl ST2
Worcester, MA 01606

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

Direct secure messaging: christine.dooley.npi1295715670.reliant@direct.optumcare.masshiway.net

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	4697	MA	Yes

Addresses

Primary practice location

50 Gold Star Blvd
Worcester, MA 01606

Mailing address

5 Neponset St FL ST2
Worcester, MA 01606-2714
Phone (508) 368-5532

Other identifiers

Identifier	Type	State	Issuer
0345911	Medicaid	MA
42396	Other		FALLON COMMUNITY HEALTH P
042472266	Other		PRIVATE HEALTHCARE SYSTEM
Y68458	Other		MEDICARE B
AA4052	Other		HARVARD PILGRIM HEALTHCAR
Y67945	Other		BLUE CARE ELECT
042472266	Other		ONE HEALTH PLAN
2779432	Other		CIGNA HEALTH PLAN
2779432001	Other		CIGNA PAL ID REFERRAL #
35481155	Other		CIGNA HEALTHSOURCE
042472266	Other		HEALTHCARE VALUE MANAGEME
650017421	Other		RAILROAD MEDICARE
785952	Other		MVP HEALTH CARE
Y67945	Other		BLUE SHIELD IDEMNITY
042472266	Other		THREE RIVERS
7367600	Other		AETNA US HEALTHCARE
Y67945	Other		BLUE SHIELD HMO BLUE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 30, 2018.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1295715670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL ST2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-368-5532",
            "fax_number": "508-853-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01606",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLEY",
        "first_name": "CHRISTINE",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "4697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0345911",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "42396",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "Y68458",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA4052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "Y67945",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "2779432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL ID REFERRAL #",
            "identifier": "2779432001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHSOURCE",
            "identifier": "35481155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGEME",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650017421",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "785952",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD IDEMNITY",
            "identifier": "Y67945",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7367600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "Y67945",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

All providers in Worcester, MA · Physical Therapist in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.