Stay Active Physical Therapy and Performance

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

STAY ACTIVE PHYSICAL THERAPY AND PERFORMANCE

Practice address

27 Tacoma St
Hyde Park, MA 02136-3203

Phone

(857) 204-6228

NPI assigned

Jun 17, 2021

Organization subpart

No

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

Authorized official

Name

Khaleel Abdul-JabbaarNPI 1780295717

Title

Physical Therapist

Phone

(857) 204-6228

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khaleel Leroy Abdul-Jabbaar, PT, DPT

  • Orthopedic Physical Therapist
  • Cambridge, MA
  • NPI 1780295717
  NPD Authorized official

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1457920118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 TACOMA ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363203",
            "telephone_number": "857-204-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 TACOMA ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363203",
            "telephone_number": "857-204-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAY ACTIVE PHYSICAL THERAPY AND PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "ABDUL-JABBAAR",
        "authorized_official_first_name": "KHALEEL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "857-204-6228"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sov Transportation LLC
• Laura Spero
• Marie Rose St Pierre
• Standhard Physical Therapy
• Christiana Stanley
• Stuart J. Macdonald, DMD, PC
• Jacqueline Sullivan
• Summit Counseling and Home Care Solutions
• Supplemantal Health Care Services
• Dafni Maria Suresh

• Physical Therapy Clinic/Center in Hyde Park, MA
• Providers in Hyde Park, MA by specialty
• Physical Therapy Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.