Individual provider Active NPI

Mia Deluccia, DPT

  • Physical Therapist
  • Bedford, MA
National Provider Identifier
1356014039
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24263 Issued in MA
Practice address
54 Middlesex Tpke Ste 101L
Bedford, MA 01730-1417
Phone
(781) 229-8011
Fax
(781) 229-8374
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 24263 MA Primary

Addresses

Primary practice location

54 Middlesex Tpke Ste 101L
Bedford, MA 01730-1417

Mailing address

54 Middlesex Tpke Ste 101L
Bedford, MA 01730-1417
Phone (781) 229-8011

Other practice location 1

100 Cummings Ctr Ste 121Q
Beverly, MA 01915-6129
Phone (978) 927-0907

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210821000072 MA Practitioner - Physical Therapist in Private Practice 9931504438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
95.5
Improvement activities
40
Cost
75.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
Proex Physical Therapy, LLC CurrentSince Sep 6, 2022 Accepting new patients

Locations

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

300 Tradecenter
Ste 1650
Woburn, MA 01801
Phone (781) 925-7643

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 2

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1356014039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MIDDLESEX TPKE STE 101L",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301417",
            "telephone_number": "781-229-8011",
            "fax_number": "781-229-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MIDDLESEX TPKE STE 101L",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301417",
            "telephone_number": "781-229-8011",
            "fax_number": "781-229-8374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Cummings Ctr Ste 121Q",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019156129",
            "country_code": "US",
            "telephone_number": "978-927-0907",
            "fax_number": "978-927-0537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELUCCIA",
        "first_name": "MIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.