Tamara Fattaleh, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22537 Issued in MA

Practice address

25 Braintree Hill Office Park
Ste L02
Braintree, MA 02184-8702

Phone

(781) 848-7300

Fax

(781) 848-5678

NPI assigned

Sep 6, 2016

Last updated

Sep 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kennedy Brothers Physical Therapy Inc.

  • Physical Therapist
  • Watertown, MA
  • NPI 1811063803
  NPD (past)

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1548717739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BRAINTREE HILL OFFICE PARK",
            "address_2": "STE L02",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021848702",
            "telephone_number": "781-848-7300",
            "fax_number": "781-848-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BRAINTREE HILL OFFICE PARK",
            "address_2": "STE L02",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021848702",
            "telephone_number": "781-848-7300",
            "fax_number": "781-848-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTALEH",
        "first_name": "TAMARA",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22537",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "2692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Evans, MS, OTR/L
• Excel Serenity Health LLC
• Eye See Eye, LLC
• Marvin Ezhan
• John Christopher Fahey, PHD
• Haley Feener, MSW, LCSW
• Donald Feeney Jr., PT,DPT
• Tinamarie Fegan, LPTA
• Richard H. Feit, MD
• Declan E Fennell, PT

• Physical Therapist in Braintree, MA
• Providers in Braintree, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.