Active NPI
Patti A. Delage, PT
- Physical Therapist
- Worcester, MA
National Provider Identifier
1437260353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6057
- Practice address
- 30 Glennie St
Worcester, MA 01605-3917 - Phone
- (508) 791-8740
- Fax
- (508) 752-3716
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- 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 Therapist | 225100000X | 6057 | MA | Primary |
Addresses
Primary practice location
30 Glennie St
Worcester, MA 01605-3917
Mailing address
30 Glennie St
Worcester, MA 01605-3917
Phone (508) 791-8740
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0334031 | Medicaid | MA | |
| 626330 | Other | MA | HARVARD PILGRIM |
| 64029 | Other | MA | AETNA |
| 981075 | Other | MA | NETWORK HEALTH |
| Y66525 | Other | MA | BLUE CROSS |
| 468028 | Other | MA | TUFTS |
| 328820 | Other | MA | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 Glennie St
Worcester, MA 01605-3924
Phone (508) 791-8740
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6057 | MA | MD | Physical Therapist |
Organizations & group practices 1
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.
-
- Physical Therapist
- Fall River, MA
- NPI 1164474334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1437260353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 GLENNIE ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053917",
"telephone_number": "508-791-8740",
"fax_number": "508-752-3716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 GLENNIE ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053917",
"telephone_number": "508-791-8740",
"fax_number": "508-752-3716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAGE",
"first_name": "PATTI",
"middle_name": "A.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "6057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0334031",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "626330",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "64029",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "981075",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "Y66525",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "468028",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "328820",
"state": "MA"
}
],
"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 Sep 2, 2021; 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.