Individual provider Active NPI

Nathaniel Ripic, DPT

  • Physical Therapist
  • West Roxbury, MA
National Provider Identifier
1437791340
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24612 Issued in MA
Practice address
1914 Centre St
West Roxbury, MA 02132-2535
Phone
(617) 323-8377
Fax
(617) 323-8077
NPI assigned
Oct 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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 24612 MA Primary

Addresses

Primary practice location

1914 Centre St
West Roxbury, MA 02132-2535

Mailing address

1 Credit Union Way FL 3
Randolph, MA 02368-4633
Phone (781) 961-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191018000763 MA Practitioner - Physical Therapist in Private Practice 4082945290 Reassigns benefits to 1 organization
I20220419001075 NY Practitioner - Physical Therapist in Private Practice 4082945290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Physical Therapy of New York, P.C.Group PAC ID 4284531674, 83 clinicians

Practice addresses (Care Compare)

285 Delaware Ave
Suite 116
Buffalo, NY 14202-1885
Phone (716) 831-8214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044760NYMDProsthodontist
24612MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy of New York, P.C. Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Oct 21, 2019 Accepting new patients

Locations

703 Granite St
Ste 3
Braintree, MA 02184

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

540 Gallivan Blvd
Ste 1
Dorchester, MA 02124
Phone (617) 282-8080

540 Gallivan Blvd
Ste 2
Dorchester, MA 02124
Phone (617) 282-8080

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1 Credit Union Way
Fl 3
Randolph, MA 02368
Phone 7819613370225

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

1914 Centre St
West Roxbury, MA 02132
Phone (617) 323-4377

285 Delaware Ave
Ste 116
Buffalo, NY 14202
Phone (716) 381-8214

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": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1437791340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY FL 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 CENTRE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322535",
            "telephone_number": "617-323-8377",
            "fax_number": "617-323-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIPIC",
        "first_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.