Individual provider Active NPI

Caitlin Cloonan

  • Physical Therapist
  • Brookline, MA
National Provider Identifier
1447734298
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23694 Issued in MA
Practice address
1842 Beacon St Ste 207
Brookline, MA 02445-1922
Phone
(617) 505-5370
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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 23694 MA Primary

Addresses

Primary practice location

1842 Beacon St Ste 207
Brookline, MA 02445-1922

Mailing address

1842 Beacon St Ste 207
Brookline, MA 02445-1922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118002154 WA Practitioner - Physical Therapist in Private Practice 3375895006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Physical Therapy CoGroup PAC ID 8820307929, 4 clinicians

Practice addresses (Care Compare)

2560 32ND Ave W
Seattle, WA 98199-3220
Phone (206) 660-1218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23694MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Physical Therapy Co CurrentSince Oct 5, 2022 Accepting new patients
Scott H. Kaye DPM PC PastSince Sep 6, 2018 Accepting new patients

Locations

2560 32nd Ave W
Seattle, WA 98199
Phone (206) 447-1570

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1447734298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST STE 207",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1842 BEACON ST STE 207",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024451922",
            "telephone_number": "617-505-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOONAN",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.