Mary an Gracie Moyer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11275 Issued in MA

Practice address

38 SW Cutoff
Northborough, MA 01532-2159

Phone

(508) 393-0890

Fax

(774) 987-3005

NPI assigned

Feb 27, 2007

Last updated

Dec 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life Care Physical Therapy

  • Physical Therapy Clinic/Center
  • Northborough, MA
  • NPI 1407279763
  NPD (past) Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1396872230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38SWCUTOFF B",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322159",
            "telephone_number": "508-393-0890",
            "fax_number": "774-987-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SW CUTOFF",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322159",
            "telephone_number": "508-393-0890",
            "fax_number": "774-987-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "MARY AN",
        "middle_name": "GRACIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER IDENTIFICATION #",
            "identifier": "20-8915668",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Morgan
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• Patricia Lyons Moriarty, MA, CCC, SLP
• Christine Frances Moulton
• Stephanie Fouad Mourad, LMHC
• Moynihan Dental Specialists LLC
• Brenda L Mulvehill, O.D.
• Munro Psychotherapy, P.C.
• Anna Munro, LICSW
• Kevin Richard Murphy, PH.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.