Individual provider Active NPI

Lori S Dacosta, PT

  • Physical Therapist
  • East Providence, RI
National Provider Identifier
1497719215
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01476 Issued in RI
Practice address
927B Warren Ave
East Providence, RI 02914-1423
Phone
(401) 438-0905
Fax
(401) 438-0903
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT01476 RI Primary

Addresses

Primary practice location

927B Warren Ave
East Providence, RI 02914-1423

Mailing address

927B Warren Ave
East Providence, RI 02914-1423
Phone (401) 438-0905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080117000603 RI Practitioner - Physical Therapist in Private Practice 5294816062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay State Physical Therapy PCGroup PAC ID 6305176850, 37 clinicians

Practice addresses (Care Compare)

2295 Diamond Hill Rd
Cumberland, RI 02864-5104
Phone (401) 305-3858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy PC Physical Therapist CurrentSince Oct 15, 2024 Accepting new patients
Healy Physical Therapy and Sports Medicine Inc Physical Therapist CurrentSince Dec 4, 2023 Accepting new patients
Sport & Spine Physical Therapy Inc Physical Therapist PastSince Apr 26, 1995 Accepting new patients

Locations

703 Granite St
Ste 300
Braintree, MA 02184
Phone (603) 626-4205

2295 Diamond Hill Rd
Cumberland, RI 02864
Phone (401) 333-3445

927 Warren Ave
#B
East Providence, RI 02914
Phone (401) 438-0905

235 Plain St
Ste 307
Providence, RI 02905
Phone (401) 414-4601

2080 Warwick Ave
Warwick, RI 02889
Phone (401) 438-0905

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1497719215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927B WARREN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141423",
            "telephone_number": "401-438-0905",
            "fax_number": "401-438-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927B WARREN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141423",
            "telephone_number": "401-438-0905",
            "fax_number": "401-438-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "LORI",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.