Individual provider Active NPI

Christopher Carreiro, DPT

  • Physical Therapist
  • Roxbury, MA
National Provider Identifier
1306494943
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24431 Issued in MA
Practice address
45 Dimock St FL 3
Roxbury, MA 02119-1208
Phone
(617) 445-0647
Fax
(617) 427-0403
NPI assigned
Aug 27, 2019
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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 24431 MA Primary

Addresses

Primary practice location

45 Dimock St FL 3
Roxbury, MA 02119-1208

Mailing address

1 Credit Union Way FL 3
Randolph, MA 02368-4633
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190905001665 MA Practitioner - Physical Therapist in Private Practice 9032448733 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24431MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc CurrentSince Aug 7, 2019 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist PastSince Sep 1, 2019 Accepting new patients

Locations

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1 Credit Union Way
Fl 3
Randolph, MA 02368

45 Dimock St
Roxbury, MA 02119

45 Dimock St
Fl 3
Roxbury, MA 02119
Phone (617) 445-0647

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1306494943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY FL 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST FL 3",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-445-0647",
            "fax_number": "617-427-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREIRO",
        "first_name": "CHRISTOPHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.

Verify at the official NPI Registry.