Active NPI
James Agostinelli
- Physical Therapy Assistant
- Revere, MA
National Provider Identifier
1306479142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9574
- Practice address
- 185 Squire Rd
Revere, MA 02151-1234 - Phone
- (781) 284-0559
- NPI assigned
- Feb 20, 2020
- Last updated
- Feb 20, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9574 | MA | Primary |
Addresses
Primary practice location
185 Squire Rd
Revere, MA 02151-1234
Mailing address
12 Green St
Billerica, MA 01821-5405
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9574 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582156800000",
"number": "1306479142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 GREEN ST",
"city": "BILLERICA",
"state": "MA",
"postal_code": "018215405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 SQUIRE RD",
"city": "REVERE",
"state": "MA",
"postal_code": "021511234",
"telephone_number": "781-284-0559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGOSTINELLI",
"first_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-20",
"last_updated": "2020-02-20",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.