Individual provider Active NPI

Madelyn Coon

  • Physical Therapist
  • South Boston, MA
National Provider Identifier
1508734179
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
88467 Issued in MA
Practice address
20 Old Colony Ave
South Boston, MA 02127-2405
Phone
(781) 664-9388
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 88467 MA Primary

Addresses

Primary practice location

20 Old Colony Ave
South Boston, MA 02127-2405

Mailing address

20 Old Colony Ave
South Boston, MA 02127-2405
Phone (781) 664-9388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251112000192 MA Practitioner - Physical Therapist in Private Practice 4486145091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliott Physical Therapy, IncGroup PAC ID 9830322585, 60 clinicians

Practice addresses (Care Compare)

20 Old Colony Ave
FL 3
South Boston, MA 02127-2405
Phone (781) 664-9388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88467MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott Physical Therapy, Inc. Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients

Locations

960 William T Morrissey Blvd
Dorchester, MA 02122
Phone (617) 506-7210

20 Old Colony Ave
Fl 3
South Boston, MA 02127
Phone (781) 664-9388

Organizations & group practices 1

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": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1508734179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272405",
            "telephone_number": "781-664-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272405",
            "telephone_number": "781-664-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "MADELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "88467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.