Individual provider Active NPI

Jeffrey Thomas Tremblay, PT

  • Orthopedic Physical Therapist
  • Agawam, MA
National Provider Identifier
1306663075
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PTL26111 Issued in MA
Practice address
68 Gold St
Agawam, MA 01001-2978
Phone
(413) 883-0145
NPI assigned
Sep 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PTL26111 MA Primary

Addresses

Primary practice location

68 Gold St
Agawam, MA 01001-2978

Mailing address

68 Gold St
Agawam, MA 01001-2978
Phone (413) 883-0145

Other identifiers 1

IdentifierTypeStateIssuer
110217828AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219000419 MA Practitioner - Physical Therapist in Private Practice 8729515424 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fit Performance and Rehab Inc. Orthopedic CurrentSince Oct 21, 2024 Accepting new patients

Locations

68 Gold St
Agawam, MA 01001
Phone (413) 883-0145

345 N Westfield St
Feeding Hills, MA 01030
Phone (413) 883-0145

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, 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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1306663075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 GOLD ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012978",
            "telephone_number": "413-883-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 GOLD ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012978",
            "telephone_number": "413-883-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMBLAY",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "PTL26111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110217828A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.