Individual provider Active NPI

Lisa Marie Giallonardo

  • Orthopedic Physical Therapist
  • Natick, MA
National Provider Identifier
1366078479
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
3696 Issued in MA
Practice address
4 Wethersfield Rd # 8
Natick, MA 01760-1770
Phone
(508) 653-6000
NPI assigned
Mar 20, 2020
Last updated
Mar 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 3696 MA Primary

Addresses

Primary practice location

4 Wethersfield Rd # 8
Natick, MA 01760-1770

Mailing address

54 Hartford St
Natick, MA 01760-2405
Phone (508) 733-3201

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL preservationptandwellness.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200408000654 MA Practitioner - Physical Therapist in Private Practice 4385073667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reform Physical Therapy LLCGroup PAC ID 8123499175, 4 clinicians

Practice addresses (Care Compare)

4 Wethersfield Rd
Suite 8
Natick, MA 01760-1770
Phone (508) 653-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3696MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reform Physical Therapy LLC. Orthopedic CurrentSince Jan 4, 2023 Accepting new patients

Locations

4 Wethersfield Rd
#8
Natick, MA 01760
Phone (508) 653-6000

4 Wethersfield Rd
Ste 8
Natick, MA 01760
Phone (508) 653-6000

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1366078479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HARTFORD ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017602405",
            "telephone_number": "508-733-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WETHERSFIELD RD # 8",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017601770",
            "telephone_number": "508-653-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIALLONARDO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "preservationptandwellness.com",
            "affiliation": "N",
            "address_1": "4 Wethersfield Rd # 8",
            "city": "Natick",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017601770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.