Active NPI
Michael E Vacon, P.T.
- Physical Therapist
- Braintree, MA
National Provider Identifier
1295740868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8581
- Practice address
- 340 Wood Rd
Suite 303
Braintree, MA 02184-2401 - Phone
- (781) 535-6053
- Fax
- (781) 535-6056
- NPI assigned
- Jul 30, 2006
- 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 | 8581 | MA | Primary |
Addresses
Primary practice location
340 Wood Rd
Suite 303
Braintree, MA 02184-2401
Mailing address
110 Haverhill Rd
Ste 524
Amesbury, MA 01913-2123
Phone (978) 388-7272
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1345513 | Other | AETNA INDIV. PIN | |
| 1804272 | Other | CIGNA INDIV. # | |
| Y66963 | Other | MA | BCBS MA INDIV # |
| 0305570 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8581 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New England Baptist Hospital | Current | 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.
-
- General Acute Care Hospital
- Roxbury Crossing, MA
- NPI 1699767491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1295740868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 HAVERHILL RD",
"address_2": "STE 524",
"city": "AMESBURY",
"state": "MA",
"postal_code": "019132123",
"telephone_number": "978-388-7272",
"fax_number": "978-388-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 WOOD RD",
"address_2": "SUITE 303",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021842401",
"telephone_number": "781-535-6053",
"fax_number": "781-535-6056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACON",
"first_name": "MICHAEL",
"middle_name": "E",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "8581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA INDIV. PIN",
"identifier": "1345513",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA INDIV. #",
"identifier": "1804272",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MA INDIV #",
"identifier": "Y66963",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0305570",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.