Individual provider Active NPI

Adam Bohmiller, PT

  • Physical Therapist
  • Cohasset, MA
National Provider Identifier
1366459919
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17562 Issued in MA
Practice address
790 Chief Justice Cushing Hwy
Cohasset, MA 02025
Phone
(781) 383-8001
Fax
(781) 383-8009
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 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 17562 MA Primary

Addresses

Primary practice location

790 Chief Justice Cushing Hwy
Cohasset, MA 02025

Mailing address

790 Chief Justice Cushing Hwy
Cohasset, MA 02025
Phone (781) 383-8001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060911000623 MA Practitioner - Physical Therapist in Private Practice 7113921859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Brothers Physical Therapy IncGroup PAC ID 9537118187, 6 clinicians

Practice addresses (Care Compare)

790 Chief Justice Cushing Hwy
Cohasset, MA 02025-2140
Phone (781) 383-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17562MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist CurrentSince Sep 17, 2015 Accepting new patients
Kennedy Brothers Physical Therapy Inc. Physical Therapist Past Accepting new patients

Locations

25 Braintree Hill Park
Ofc P
Braintree, MA 02184
Phone (781) 444-1614

790 Chief Justice Cushing Hwy
Cohasset, MA 02025
Phone (781) 383-1525

15 Oak St
Ste 1
Needham, MA 02492
Phone (781) 444-1614

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1366459919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CHIEF JUSTICE CUSHING HWY",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "02025",
            "telephone_number": "781-383-8001",
            "fax_number": "781-383-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHIEF JUSTICE CUSHING HWY",
            "city": "COHASSET",
            "state": "MA",
            "postal_code": "02025",
            "telephone_number": "781-383-8001",
            "fax_number": "781-383-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHMILLER",
        "first_name": "ADAM",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cohasset, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.