Declan E Fennell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13347 Issued in MA

Practice address

16 Sycamore Rd
Braintree, MA 02184-7308

Phone

(617) 333-8389

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Focus Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Braintree, MA
  • NPI 1164191219
  NPD Authorized official

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366481608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SYCAMORE RD",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847308",
            "telephone_number": "617-333-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SYCAMORE RD",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021847308",
            "telephone_number": "617-333-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "DECLAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "13347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "603413",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "102302300",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6440025",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y67710",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "458473",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "8211",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Fattaleh, DPT, ATC
• Haley Feener, MSW, LCSW
• Donald Feeney Jr., PT,DPT
• Tinamarie Fegan, LPTA
• Richard H. Feit, MD
• Krista M Fernandes
• Luz M Fernandez Rodriguez
• Amaka Jessica Fez, PMHNP
• April Renee Figueiredo, ABA THERAPIST
• Shannon Finlay

• Physical Therapist in Braintree, MA
• Providers in Braintree, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.