Individual provider Active NPI

Max Ryan Demartino, DPT

  • Physical Therapist
  • Springfield, MA
National Provider Identifier
1346958543
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
348 Cooley St Unit 10
Springfield, MA 01128-1144
Phone
(413) 355-5700
Fax
(413) 526-9961
NPI assigned
Nov 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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 MA Primary
Physical Therapist 225100000X 012906 CT

Addresses

Primary practice location

348 Cooley St Unit 10
Springfield, MA 01128-1144

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

168 Denslow Rd
East Longmeadow, MA 01028-3188
Phone (413) 526-9924

Other practice location 2

715 Lakewood Rd
Waterbury, CT 06704-5400
Phone (203) 598-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231030000899 MA Practitioner - Physical Therapist in Private Practice 1456707348 Reassigns benefits to 1 organization
I20240701000322 TN Practitioner - Physical Therapist in Private Practice 1456707348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Rehabilitation of Western New England LLCGroup PAC ID 7911979950, 201 clinicians

Practice addresses (Care Compare)

168 Denslow Rd
East Longmeadow, MA 01028-3188
Phone (413) 526-9924

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012906CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Nov 6, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Nov 6, 2023 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

168 Denslow Rd
East Longmeadow, MA 01028
Phone (413) 526-9924

84 Willimansett St
South Hadley, MA 01075
Phone (413) 533-8501

348 Cooley St
Unit 10
Springfield, MA 01128
Phone (413) 355-5700

1525 Gunbarrel Rd
Ste 105
Chattanooga, TN 37421
Phone (423) 894-4188

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1346958543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 COOLEY ST UNIT 10",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011281144",
            "telephone_number": "413-355-5700",
            "fax_number": "413-526-9961"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "168 Denslow Rd",
            "address_purpose": "LOCATION",
            "city": "East Longmeadow",
            "state": "MA",
            "postal_code": "010283188",
            "country_code": "US",
            "telephone_number": "413-526-9924",
            "fax_number": "413-526-9961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Lakewood Rd",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067045400",
            "country_code": "US",
            "telephone_number": "203-598-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARTINO",
        "first_name": "MAX",
        "middle_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "012906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.