NPIMap

Organization Active NPI

Active Motion Physical Therapy

  • Orthopedic Physical Therapist
  • Wakefield, MA
National Provider Identifier
1306979604
Registry record updated Mar 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
6151 Issued in MA
Legal business name
ACTIVE MOTION PHYSICAL THERAPY
Practice address
414 Main St
Wakefield, MA 01880-3018
Phone
(781) 245-0055
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2009

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

Authorized official

Name
Thomas J Allardi, PTNPI 1114148608
Title
President
Phone
(781) 245-0055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X 6151 MA Primary

Addresses

Primary practice location

414 Main St
Wakefield, MA 01880-3018

Mailing address

414 Main St
Wakefield, MA 01880-3018
Phone (781) 245-0055

Other identifiers 4

IdentifierTypeStateIssuer
Y61463OtherMABCBS
820711OtherMATUFTS
307618OtherMAHARVARD PILGRIM
0363529MedicaidMA

Other names 1

  • Aquatic Myofascial Physical Therapy, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050427000223 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052350394 Receives reassigned benefits from 8 practitioners
Practice locations: Wakefield, MA

National Provider Directory

National Provider Directory

Locations

7 Lincoln St
Ste 310
Wakefield, MA 01880
Phone (781) 245-0055

414 Main St
Wakefield, MA 01880
Phone (781) 245-0055

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236470400000",
    "number": "1306979604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803018",
            "telephone_number": "781-245-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803018",
            "telephone_number": "781-245-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MOTION PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-03-08",
        "status": "A",
        "authorized_official_last_name": "ALLARDI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-245-0055",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "6151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y61463",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "820711",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "307618",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0363529",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aquatic Myofascial Physical Therapy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2009; 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.