NPIMap

Organization Active NPI

Performance Rehabilitation of Western New England LLC

Doing business as ATI Physical Therapy of Western Massachusetts

  • Occupational Therapist
  • Springfield, MA
National Provider Identifier
1447445523
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC
Doing business as
ATI Physical Therapy of Western Massachusetts
Practice address
300 Birnie Ave
Suite 304
Springfield, MA 01107
Phone
(413) 781-1054
Fax
(413) 439-0026
NPI assigned
Sep 11, 2007
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Wade A MeyerNPI 1396837498
Title
VP Chief Compliance Officer
Phone
(630) 296-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X MA
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X MA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X MA Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X MA

Addresses

Primary practice location

300 Birnie Ave
Suite 304
Springfield, MA 01107

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other identifiers 10

IdentifierTypeStateIssuer
972730OtherMANETWORK HEALTH
000000035257OtherMABOSTON MEDICAL CENTER
103355100OtherMADEPT OF LABOR
043527OtherMACT CARE
64-04290OtherMAUNITED
Y61264OtherMABLUE SHIEL PT
690675OtherMATUFTS
28117OtherMAHNE
9715668MedicaidMA
OG0011OtherMABLUE SHIELD OT

Other names 1

  • ATI Physical Therapy of Western Massachusetts Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040810000712 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911979950 Receives reassigned benefits from 327 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, MA; Natick, MA; Newton, MA; Norwell, MA; Peabody, MA; Saugus, MA; Somerville, MA; South Hadley, MA…
O20100930031234 MA DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 7911979950 Practice locations: Springfield, MA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1447445523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE",
            "address_2": "SUITE 304",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01107",
            "telephone_number": "413-781-1054",
            "fax_number": "413-439-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "630-296-2222"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "972730",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOSTON MEDICAL CENTER",
            "identifier": "000000035257",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "103355100",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT CARE",
            "identifier": "043527",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "64-04290",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIEL PT",
            "identifier": "Y61264",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "690675",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HNE",
            "identifier": "28117",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9715668",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OT",
            "identifier": "OG0011",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATI Physical Therapy of Western Massachusetts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.