Active NPI
Michelina Cassella Kulak, PT
- Pediatric Physical Therapist
- Boston, MA
National Provider Identifier
1457561763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1146
- Practice address
- 300 Longwood Ave
Farley 6
Boston, MA 02211-0001 - Phone
- (617) 355-7223
- Fax
- (617) 730-0151
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1146 | MA | Primary |
Addresses
Primary practice location
300 Longwood Ave
Farley 6
Boston, MA 02211-0001
Mailing address
300 Longwood Ave
Farley 6
Boston, MA 02211-0001
Phone (617) 355-7223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1146 | MA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1457561763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "FARLEY 6",
"city": "BOSTON",
"state": "MA",
"postal_code": "022110001",
"telephone_number": "617-355-7223",
"fax_number": "617-730-0151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "FARLEY 6",
"city": "BOSTON",
"state": "MA",
"postal_code": "022110001",
"telephone_number": "617-355-7223",
"fax_number": "617-730-0151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULAK",
"first_name": "MICHELINA",
"middle_name": "CASSELLA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "MA",
"license": "1146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.