Active NPI
Ryan O'Malley, PTA
- Physical Therapy Assistant
- Chestnut Hill, MA
National Provider Identifier
1487298030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9723
- Practice address
- 615 Heath St
Chestnut Hill, MA 02467-2160 - Phone
- (617) 243-9990
- NPI assigned
- Nov 6, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9723 | MA | Primary |
Addresses
Primary practice location
615 Heath St
Chestnut Hill, MA 02467-2160
Mailing address
39 Ian Keats Dr
Mansfield, MA 02048-3252
Phone (774) 266-6697
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 |
|---|---|---|---|
| 9723 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1487298030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 IAN KEATS DR",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020483252",
"telephone_number": "774-266-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 HEATH ST",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672160",
"telephone_number": "617-243-9990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'MALLEY",
"first_name": "RYAN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-06",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chestnut Hill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.