NPIMap

Organization Active NPI

Physical Therapy of Mattapan Square, LLC

  • Physical Therapy Clinic/Center
  • Mattapan, MA
National Provider Identifier
1447609938
Registry record updated Jun 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSICAL THERAPY OF MATTAPAN SQUARE, LLC
Practice address
1596 Blue Hill Ave
Mattapan, MA 02126-2121
Phone
(617) 296-6800
Fax
(617) 296-6810
NPI assigned
Jun 6, 2016
Last updated
Jun 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2016

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

Authorized official

Name
Mr. Hassan Monroe
Title
President
Phone
(617) 784-3166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1596 Blue Hill Ave
Mattapan, MA 02126-2121

Mailing address

1596 Blue Hill Ave
Mattapan, MA 02126-2121
Phone (617) 296-6800

National Provider Directory

National Provider Directory

Locations

1596 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-6800

Practitioners & affiliated clinicians

Practitioners 4

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": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465603200000",
    "number": "1447609938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262121",
            "telephone_number": "617-296-6800",
            "fax_number": "617-296-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1596 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262121",
            "telephone_number": "617-296-6800",
            "fax_number": "617-296-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY OF MATTAPAN SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-11",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-784-3166",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.