Individual provider Active NPI

Tiffany Lao

  • Physical Therapist
  • Pawtucket, RI
National Provider Identifier
1346016862
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT04097 Issued in RI
Practice address
21 Division St
Pawtucket, RI 02860-5352
Phone
(401) 226-0545
Fax
(401) 721-5214
NPI assigned
Nov 27, 2023
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT04097 RI Primary
Physical Therapist 225100000X PA

Addresses

Primary practice location

21 Division St
Pawtucket, RI 02860-5352

Mailing address

4 Richmond SQ
Providence, RI 02906-5117
Phone (401) 433-4172

Other practice location 1

169 Levittown Pkwy Ste D
Levittown, PA 19055-2463
Phone (215) 377-9932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231207001126 PA Practitioner - Physical Therapist in Private Practice 0840649505 Reassigns benefits to 1 organization
I20260304001962 RI Practitioner - Physical Therapist in Private Practice 0840649505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians

Practice addresses (Care Compare)

169 Levittown Pkwy
Suite D
Levittown, PA 19055-2463
Phone (215) 377-9932

21 Division St
Pawtucket, RI 02860-5301
Phone (401) 726-7100

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT04097RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Mar 2, 2026 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 11, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Dec 11, 2023 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Mar 2, 2026 Accepting new patients
Ati Holdings, LLC PastSince Apr 13, 2025 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

775 Huntingdon Pike
Huntingdon Valley, PA 19006
Phone (215) 690-5575

169 Levittown Pkwy
Ste D
Levittown, PA 19055
Phone (215) 377-9932

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

9475 Roosevelt Blvd
#B4
Philadelphia, PA 19114
Phone (215) 464-6200

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

468 2nd Street Pike
Southampton, PA 18966
Phone (215) 876-6692

21 Division St
Pawtucket, RI 02860

4 Richmond Sq
Providence, RI 02906
Phone (401) 885-2821

Organizations & group practices 5

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1346016862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DIVISION ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605352",
            "telephone_number": "401-226-0545",
            "fax_number": "401-721-5214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Levittown Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "PA",
            "postal_code": "190552463",
            "country_code": "US",
            "telephone_number": "215-377-9932",
            "fax_number": "267-839-7203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAO",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT04097",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.