Individual provider Active NPI

Mariah Allen, DPT

  • Physical Therapist
  • Bourne, MA
National Provider Identifier
1356125231
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27042 Issued in MA
Practice address
123 Waterhouse Rd Ste 204
Bourne, MA 02532-3890
Phone
(508) 743-7215
Fax
(774) 247-4397
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 27042 MA Primary

Addresses

Primary practice location

123 Waterhouse Rd Ste 204
Bourne, MA 02532-3890

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920001908 MA Practitioner - Physical Therapist in Private Practice 3375997679 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

Practice addresses (Care Compare)

123 Waterhouse Rd
Suite 204
Bourne, MA 02532-3890
Phone (508) 743-7215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27042MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Aug 9, 2023 Accepting new patients

Locations

123 Waterhouse Rd
Ste 204
Bourne, MA 02532
Phone (508) 743-7215

703 Granite St
Ste 3
Braintree, MA 02184

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

205 Worcester Ct
Ste 3B
Falmouth, MA 02540
Phone (774) 349-0026

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

Organizations & group practices 1

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1356125231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WATERHOUSE RD STE 204",
            "city": "BOURNE",
            "state": "MA",
            "postal_code": "025323890",
            "telephone_number": "508-743-7215",
            "fax_number": "774-247-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARIAH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourne, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.