NPIMap

Organization Active NPI

Premise Health of Massachusetts, Medical PC

Doing business as Liberty Mutual Physical Therapy

  • Physical Therapy Clinic/Center
  • Boston, MA
National Provider Identifier
1316585482
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC
Doing business as
Liberty Mutual Physical Therapy
Practice address
157 Berkeley St
Boston, MA 02116-5108
Phone
(857) 224-9355
Fax
(857) 224-8373
NPI assigned
Dec 19, 2019
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Dr. Jonathan Leizman, MDNPI 1447249677
Title
President
Phone
(216) 479-9063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

157 Berkeley St
Boston, MA 02116-5108

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • Liberty Mutual Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Massachusetts Medical PC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

156 Berkeley St
Boston, MA 02116

5500 Maryland Way
Ste 120
Brentwood, TN 37027

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1316585482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 BERKELEY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165108",
            "telephone_number": "857-224-9355",
            "fax_number": "857-224-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Mutual Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liberty Mutual Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.