Active NPI
Jeffrey D Sivert, PTA
- Physical Therapy Assistant
- Worcester, MA
National Provider Identifier
1407906191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 7780
- Practice address
- 255 Park Ave
Suite 400
Worcester, MA 01609-1953 - Phone
- (508) 755-7272
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 7780 | MA | Primary |
Addresses
Primary practice location
255 Park Ave
Suite 400
Worcester, MA 01609-1953
Mailing address
14 Highland St
Clinton, MA 01510-1027
Phone (978) 580-9745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7780 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407906191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 HIGHLAND ST",
"city": "CLINTON",
"state": "MA",
"postal_code": "015101027",
"telephone_number": "978-580-9745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PARK AVE",
"address_2": "SUITE 400",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091953",
"telephone_number": "508-755-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIVERT",
"first_name": "JEFFREY",
"middle_name": "D",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "7780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.