Meredith R Izzicupo, PT, DPT, SCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20685 Issued in MA

Practice address

5 Middlesex Ave
Cambridge Health Alliance
Somerville, MA 02145

Phone

(617) 591-4660

NPI assigned

Sep 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Meredith R Harclerode Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Valencia Physical Therapy, PLLC

  • Physical Therapist
  • Tewksbury, MA
  • NPI 1558087130
  NPD Authorized official

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1457786204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 RIVER ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018323542",
            "telephone_number": "201-317-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "address_2": "CAMBRIDGE HEALTH ALLIANCE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02145",
            "telephone_number": "617-591-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZICUPO",
        "first_name": "MEREDITH",
        "middle_name": "R",
        "credential": "PT, DPT, SCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "HARCLERODE",
            "middle_name": "R",
            "credential": "PT, DPT, SCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adriana Cristina Soro Isaac, PTA
• Joshua Isaac, ATC
• Zhala Isayeva
• Anthony Mark Ishak, PHARM.D.
• Ramesh Izedian, D.M.D.
• J. G. Dental Inc
• J&M World Class Services Inc
• Paola Jaar, DPT
• Erika K Jackson, LCSW
• Danielle Marie Jacobsen, PA-C

• Physical Therapist in Somerville, MA
• Providers in Somerville, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.