Individual provider Active NPI

Amanda Driscoll, DPT

  • Physical Therapist
  • Norwood, MA
National Provider Identifier
1407300882
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
99 Vanderbilt Ave
Norwood, MA 02062-5011
Phone
(781) 352-5400
Fax
(781) 352-5400
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 Primary

Addresses

Primary practice location

99 Vanderbilt Ave
Norwood, MA 02062-5011

Mailing address

250 E Main St
Norton, MA 02766-2436
Phone (508) 285-5533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031002006 MA Practitioner - Physical Therapist in Private Practice 7214215961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marathon Physical Therapy and Sports Medicine, LLCGroup PAC ID 3779554738, 34 clinicians

Practice addresses (Care Compare)

99 Vanderbilt Ave
Norwood, MA 02062-5011
Phone (781) 352-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Jan 3, 2022 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist PastSince Jan 3, 2022 Accepting new patients

Locations

250 E Main St
Norton, MA 02766
Phone (508) 285-5533

99 Vanderbilt Ave
Norwood, MA 02062
Phone (781) 352-5400

Organizations & group practices 2

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1407300882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E MAIN ST",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027662436",
            "telephone_number": "508-285-5533",
            "fax_number": "508-285-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 VANDERBILT AVE",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625011",
            "telephone_number": "781-352-5400",
            "fax_number": "781-352-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.