Organization Active NPI

Step Ahead Physical Therapy

  • Physical Therapy Clinic/Center
  • Somerville, MA
National Provider Identifier
1528363116
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
11191 Issued in MA
Legal business name
STEP AHEAD PHYSICAL THERAPY
Practice address
5 Middlesex Ave
Suite 203
Somerville, MA 02145-1102
Phone
(617) 240-9303
NPI assigned
Jan 13, 2011
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Andrew CiarlettaNPI 1962554774
Title
Owner
Phone
(617) 240-9303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 11191 MA Primary

Addresses

Primary practice location

5 Middlesex Ave
Suite 203
Somerville, MA 02145-1102

Mailing address

111 Water St Apt 7
Beverly, MA 01915-5060

Other identifiers 1

IdentifierTypeStateIssuer
Y67613OtherMABLUE CROSS/BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110603000421 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931386752 Receives reassigned benefits from 3 practitioners
Practice locations: Marblehead, MA

National Provider Directory

National Provider Directory

Locations

50 Doaks Ln
Marblehead, MA 01945
Phone (617) 420-2041

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1528363116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WATER ST APT 7",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "address_2": "SUITE 203",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451102",
            "telephone_number": "617-240-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEP AHEAD PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "CIARLETTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-240-9303"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "11191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "Y67613",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.