Individual provider Active NPI

Joshua Keough, DPT

  • Physical Therapist
  • Dracut, MA
National Provider Identifier
1396529343
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27069 Issued in MA
Practice address
1095 Lakeview Ave
Dracut, MA 01826-4718
Phone
(978) 955-9448
NPI assigned
Aug 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 27069 MA Primary

Addresses

Primary practice location

1095 Lakeview Ave
Dracut, MA 01826-4718

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905003488 MA Practitioner - Physical Therapist in Private Practice 6305209529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1095 Lakeview Ave
Dracut, MA 01826-4718
Phone (781) 961-3370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27069MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Aug 10, 2023 Accepting new patients

Locations

703 Granite St
Ste 3
Braintree, MA 02184

703 Granite St
Ste 300
Braintree, MA 02184
Phone (603) 626-4205

703 Granite St
Fl 3
Braintree, MA 02184

1095 Lakeview Ave
Dracut, MA 01826
Phone (978) 955-9448

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1396529343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 LAKEVIEW AVE",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018264718",
            "telephone_number": "978-955-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOUGH",
        "first_name": "JOSHUA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dracut, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.