NPIMap

Organization Active NPI

Orthosports & Aquatic Physical Therapy, PC

Doing business as OrthoSportsMED Physical Therapy

  • Physical Therapist
  • Needham, MA
National Provider Identifier
1407803935
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10955 Issued in MA
Legal business name
ORTHOSPORTS & AQUATIC PHYSICAL THERAPY, PC
Doing business as
OrthoSportsMED Physical Therapy
Practice address
1237 Highland Ave
Needham, MA 02492-2615
Phone
(781) 444-1290
Fax
(866) 305-1388
NPI assigned
May 29, 2006
Last updated
Aug 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Authorized official

Name
Mr. Kipp Kevin Dye, MSPTNPI 1063585651
Title
President
Phone
(781) 444-1290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10955 MA Primary

Addresses

Primary practice location

1237 Highland Ave
Needham, MA 02492-2615

Mailing address

1237 Highland Ave
Needham, MA 02492-2615
Phone (781) 444-1290

Other names 1

  • OrthoSportsMED Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000751 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921903121 Receives reassigned benefits from 9 practitioners
Practice locations: East Harwich, MA; Needham, MA

National Provider Directory

National Provider Directory

Locations

1237 Highland Ave
Needham, MA 02492
Phone (781) 444-1290

1451 Highland Ave
Needham, MA 02492
Phone (781) 444-1290

125 Adams St
#3
Newton, MA 02458
Phone (617) 965-8070

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1407803935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922615",
            "telephone_number": "781-444-1290",
            "fax_number": "866-305-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HIGHLAND AVE",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922615",
            "telephone_number": "781-444-1290",
            "fax_number": "866-305-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOSPORTS & AQUATIC PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "DYE",
        "authorized_official_first_name": "KIPP",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-444-1290",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "10955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoSportsMED Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.