Individual provider Active NPI

Conlan Brown

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1407334568
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
648 Beacon St Ste 2
Boston, MA 02215-2013
Phone
(617) 536-1161
NPI assigned
Aug 1, 2018
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 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

648 Beacon St Ste 2
Boston, MA 02215-2013

Mailing address

145 Lincoln Ave
Amherst, MA 01002-2009
Phone (413) 363-7689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180924002309 MA Practitioner - Physical Therapist in Private Practice 9537410998 Reassigns benefits to 1 organization
I20240716001696 WA Practitioner - Physical Therapist in Private Practice 9537410998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stride Physio PLLCGroup PAC ID 9234432014, 9 clinicians

Practice addresses (Care Compare)

100 NE Northlake Way
Suite 200B
Seattle, WA 98105-6871
Phone (206) 547-7445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Feb 11, 2021 Accepting new patients
Morgan Kriz PLLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Back to Work Prevention & Physical Therapy, Inc. CurrentSince Jun 10, 2024 Accepting new patients
Stride Physio PLLC CurrentSince Oct 14, 2024 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Feb 11, 2021 Accepting new patients

Locations

648 Beacon St
Boston, MA 02215
Phone (617) 353-9345

648 Beacon St
Ste 2
Boston, MA 02215

100 NE Northlake Way
Ste 200B
Seattle, WA 98105
Phone (206) 295-3870

5620 Rainier Ave S
Ste 102
Seattle, WA 98118
Phone (206) 535-8061

Organizations & group practices 5

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1407334568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LINCOLN AVE",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022009",
            "telephone_number": "413-363-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 BEACON ST STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152013",
            "telephone_number": "617-536-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CONLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.