Active NPI
Alexandra Tedesco
- Occupational Therapist
- Waltham, MA
National Provider Identifier
1306416771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13894
- Practice address
- 179 Bear Hill Rd
Waltham, MA 02451-1063 - Phone
- (781) 895-9500
- NPI assigned
- Jun 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13894 | MA | Primary |
Addresses
Primary practice location
179 Bear Hill Rd
Waltham, MA 02451-1063
Mailing address
179 Bear Hill Rd
Waltham, MA 02451-1063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multiple Sclerosis Specialty Center, LLC | Current | Accepting new patients |
Locations
179 Bear Hill Rd
Ste 105
Waltham, MA 02451
Phone (781) 895-9500
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.
-
dba 810 MS Specialty Center
- Neurology Physical Therapist
- Waltham, MA
- NPI 1831594282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1306416771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 BEAR HILL RD",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 BEAR HILL RD",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511063",
"telephone_number": "781-895-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCO",
"first_name": "ALEXANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "13894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.