Individual provider Active NPI

Mark P Gorman, DPT

  • Physical Therapist
  • Lexington, MA
National Provider Identifier
1306157490
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19091 Issued in MA
Practice address
57 Bedford St
Ste 202
Lexington, MA 02420-4500
Phone
(781) 541-5111
Fax
(781) 541-5115
NPI assigned
Jun 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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 19091 MA Primary

Addresses

Primary practice location

57 Bedford St
Ste 202
Lexington, MA 02420-4500

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110411000437 MA Practitioner - Physical Therapist in Private Practice 2163606419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Northeastern Ohio University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians

Practice addresses (Care Compare)

101 University Dr
Suite A6
Amherst, MA 01002-2385
Phone (413) 336-5703

2 Icehouse Rd
Medfield, MA 02052-1555
Phone (508) 242-9478

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

State licenses

LicenseStateTypeSpecialty
19091MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Feb 1, 2018 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Feb 1, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

340 Great Rd
Acton, MA 01720
Phone (978) 287-6170

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

85 Franklin St
Boston, MA 02110
Phone (857) 284-4399

1661 Worcester Rd
Ste 105
Framingham, MA 01701
Phone (508) 626-2600

57 Bedford St
Ste 202
Lexington, MA 02420
Phone (781) 541-5111

2 Icehouse Rd
Medfield, MA 02052
Phone (508) 242-9478

947 Worcester St
Natick, MA 01760
Phone (508) 720-0258

141 Boston Post Rd
Sudbury, MA 01776
Phone (781) 541-5111

530 Boston Post Rd
Ste B
Sudbury, MA 01776
Phone (978) 639-4800

24 Lyman St
Ste 120
Westborough, MA 01581
Phone (508) 366-1433

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.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1306157490",
    "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",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEDFORD ST",
            "address_2": "STE 202",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204500",
            "telephone_number": "781-541-5111",
            "fax_number": "781-541-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.