Individual provider Active NPI

Sean O'Shaughnessy, DPT

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1447799341
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22859 Issued in MA
Practice address
300 Tradecenter
Suite 1650
Woburn, MA 01801-1883
Phone
(781) 935-2655
Fax
(781) 935-9097
NPI assigned
Feb 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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 22859 MA Primary

Addresses

Primary practice location

300 Tradecenter
Suite 1650
Woburn, MA 01801-1883

Mailing address

210 Commerce Way
Suite 120
Portsmouth, NH 03801-8200
Phone (603) 427-8066

Other identifiers 1

IdentifierTypeStateIssuer
22859OtherMALIC #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215000090 MA Practitioner - Physical Therapist in Private Practice 6406139526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

300 Tradecenter
Suite 1650
Woburn, MA 01801-1884
Phone (781) 935-2655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22859MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC CurrentSince Feb 13, 2017 Accepting new patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Feb 13, 2017 Accepting new patients
Proex Physical Therapy, LLC Past Accepting new patients
Competitive Edge Physical Therapy & Sports Training, LLC Physical Therapist Past Accepting new patients

Locations

110 Haverhill Rd
Ste 292
Amesbury, MA 01913
Phone (978) 834-6392

11 Water St
Ste 3A
Arlington, MA 02476
Phone (781) 777-1416

44 School St
Rm 350
Boston, MA 02108
Phone (617) 213-1336

607 Boylston St
Fl 4
Boston, MA 02116
Phone (857) 240-0909

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

400 Franklin St
Ste 200
Braintree, MA 02184
Phone (781) 214-6544

63 Pleasant St
Fl 2
Watertown, MA 02472
Phone (617) 213-1335

300 Tradecenter
Ste 1650
Woburn, MA 01801
Phone (781) 925-7643

210 Commerce Way
Ste 120
Portsmouth, NH 03801
Phone (603) 427-8066

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 4

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1447799341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COMMERCE WAY",
            "address_2": "SUITE 120",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038018200",
            "telephone_number": "603-427-8066",
            "fax_number": "603-501-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TRADECENTER",
            "address_2": "SUITE 1650",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011883",
            "telephone_number": "781-935-2655",
            "fax_number": "781-935-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHAUGHNESSY",
        "first_name": "SEAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC #",
            "identifier": "22859",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.