Individual provider Active NPI

Stacy F Patten, DPT

  • Physical Therapist
  • Plymouth, MA
National Provider Identifier
1548682867
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20905 Issued in MA
Practice address
46 Long Pond Rd
Plymouth, MA 02360-2606
Phone
(774) 283-4387
NPI assigned
Jan 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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 20905 MA Primary

Addresses

Primary practice location

46 Long Pond Rd
Plymouth, MA 02360-2606

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140523001461 MA Practitioner - Physical Therapist in Private Practice 5890918692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

55 R Washington St
Norwell, MA 02061-1715
Phone (781) 871-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20905MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Mar 30, 2018 Accepting new patients
Proex Physical Therapy, LLC CurrentSince Mar 30, 2018 Accepting new patients

Locations

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

31 W Grove St
Middleboro, MA 02346
Phone (508) 947-5195

55R Washington St
Norwell, MA 02061
Phone (781) 871-9500

46 Long Pond Rd
Plymouth, MA 02360
Phone (774) 283-4387

385 Washington St
Quincy, MA 02169
Phone (617) 479-1434

700 Myles Standish Blvd
Taunton, MA 02780
Phone (508) 824-9022

576 Broadhollow Rd
Melville, NY 11747

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.

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1548682867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 LONG POND RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602606",
            "telephone_number": "774-283-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTEN",
        "first_name": "STACY",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.