Jesse J. Little, PT

Key facts

NPI

1467697490

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapist 225100000X

License

18481 (MA)

Practice address

135 Gold Star Blvd
Worcester, MA 01606-2738

Phone

(508) 856-9510

Fax

(508) 853-1907

NPI assigned

Dec 4, 2008

Sex

Male

Sole proprietor

No

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.

• Reliant Medical Group, Inc Physical Therapist · Worcester, MA · NPI 1295827962
  Medicare reassignment Care Compare group NPD MA · PHYSICAL THERAPIST
• Reliant Medical Group, Inc Family Medicine Physician · Worcester, MA · NPI 1720017528
  Care Compare group NPD

Medicare Care Compare profile

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reliant Medical Group Inc (638 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MA

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.little.npi1467697490.reliant@direct.optumcare.masshiway.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 17, 2009.

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1467697490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062738",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "JESSE",
        "middle_name": "J.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

• Veronica Margaret Watkins Listerud, MSW, LICSW
• Ryan Keith Litchfield
• Alice L Litter, LICSW
• Little Smiles Dental
• Caitlin Little
• Kamai Little
• Ryann M Little, MD
• Gita Littlejohn
• Kathrine Littlejohn, FNP-C
• Kristin Littlepage, RN

All providers in Worcester, MA · Physical Therapist in Massachusetts