Individual provider Active NPI

Brandon P Lawlor, PT

  • Physical Therapist
  • South Hadley, MA
National Provider Identifier
1396343125
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25052 Issued in MA
Practice address
84 Willimansett St
South Hadley, MA 01075-3097
Phone
(413) 533-8501
Fax
(413) 533-8502
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 25052 MA Primary

Addresses

Primary practice location

84 Willimansett St
South Hadley, MA 01075-3097

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

415 Neponset Ave Ste 2B
Dorchester, MA 02122-3169
Phone (617) 287-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201103000160 MA Practitioner - Physical Therapist in Private Practice 5991115974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Orthopaedic PCGroup PAC ID 2264702109, 4 clinicians

Practice addresses (Care Compare)

307 S Main St
Fall River, MA 02721-5309
Phone (508) 675-2840

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Boston Orthopaedic PC Physical Therapist CurrentSince Feb 25, 2024 Accepting new patients
Fortitude Physical Therapy and Performance LLC Current Accepting new patients
Comeback Physical Therapy, Inc. Physical Therapist CurrentSince Jun 27, 2022 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

415 Neponset Ave
Ste 2B
Dorchester, MA 02122
Phone (617) 287-2225

307 S Main St
Fall River, MA 02721
Phone (508) 675-2840

84 Willimansett St
South Hadley, MA 01075
Phone (413) 533-8501

966 Park St
Ste A2
Stoughton, MA 02072
Phone (781) 341-1000

Organizations & group practices 6

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": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1396343125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 WILLIMANSETT ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010753097",
            "telephone_number": "413-533-8501",
            "fax_number": "413-533-8502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Neponset Ave Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021223169",
            "country_code": "US",
            "telephone_number": "617-287-2225",
            "fax_number": "617-287-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWLOR",
        "first_name": "BRANDON",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hadley, MA

Sources for this page

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