Domenic F. Sulfaro Jr., PT, DPT, LATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

624 Issued in MA

Practice address

541 Main St
Suite 103
South Weymouth, MA 02190-1868

Phone

(781) 331-9600

Fax

(781) 335-1556

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Proex Physical Therapy, LLC

  • Physical Therapist
  • Woburn, MA
  • NPI 1831190453
  Medicare reassignment Care Compare group NPD
• South Shore Sports & Muscular

  • Orthopedic Physical Therapist
  • East Weymouth, MA
  • NPI 1104822576
  Medicare reassignment NPD
• Proex Physical Therapy, LLC

  • Occupational Therapist
  • Boston, MA
  • NPI 1508757956
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1336250356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901868",
            "telephone_number": "781-331-9600",
            "fax_number": "781-335-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901868",
            "telephone_number": "781-331-9600",
            "fax_number": "781-335-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULFARO",
        "first_name": "DOMENIC",
        "middle_name": "F.",
        "name_suffix": "Jr.",
        "credential": "PT, DPT, LATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16543",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "626330",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "981075",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "328820",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "470490",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0329720",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y68210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "64029",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Harris Stephen, MD
• Steven D Garland DMD PC
• Nathaniel Stillman, PA-C
• Joshua West Stuhlfaut, MD
• Henry Su, MD, PHD
• Richard F Sullivan, MD
• James N Suojanen, MD
• Shiv Sutaria, MD
• Chester Parker Swett, M.D.
• Patricia I Tai, MD

• Athletic Trainer in South Weymouth, MA
• Providers in South Weymouth, MA by specialty
• Athletic Trainer in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.