Individual provider Active NPI

Amanda Leigh Griffin, PT

  • Physical Therapist
  • Malden, MA
National Provider Identifier
1386935047
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19475 Issued in MA
Practice address
350 Main St
1St Floor, Commence Place
Malden, MA 02148-5089
Phone
(781) 321-2727
NPI assigned
Apr 28, 2011
Last updated
Jun 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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 19475 MA Primary

Addresses

Primary practice location

350 Main St
1St Floor, Commence Place
Malden, MA 02148-5089

Mailing address

27 Norwood St
Malden, MA 02148-4109
Phone (732) 778-7908

Other names 1

  • Amanda Leigh Brizendine Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110711000182 MA Practitioner - Physical Therapist in Private Practice 2163600412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

180 Main St
Walpole, MA 02081-4020
Phone (774) 847-7214

25 Cobb St
Mansfield, MA 02048-4505
Phone (508) 471-5392

86 Saunders Rd
Norwood, MA 02062-3242
Phone (781) 285-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19475MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
McGovern Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Byron V Hartunian MD PC Past Accepting new patients

Organizations & group practices 4

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1386935047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 NORWOOD ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484109",
            "telephone_number": "732-778-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MAIN ST",
            "address_2": "1ST FLOOR, COMMENCE PLACE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485089",
            "telephone_number": "781-321-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "19475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BRIZENDINE",
            "middle_name": "LEIGH",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.