NPIMap

Organization Active NPI

Valencia Physical Therapy, PLLC

  • Physical Therapist
  • Tewksbury, MA
National Provider Identifier
1558087130
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
VALENCIA PHYSICAL THERAPY, PLLC
Practice address
1565 Main St
Tewksbury, MA 01876-2085
Phone
(978) 328-0768
NPI assigned
Oct 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Meredith Izzicupo, PT, DPT, SCSNPI 1457786204
Title
Managing Member
Phone
(201) 317-9683

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1565 Main St
Tewksbury, MA 01876-2085

Mailing address

733 Turnpike St # 112
North Andover, MA 01845-6137
Phone (978) 328-0768

National Provider Directory

National Provider Directory

Locations

733 Turnpike St
#112
North Andover, MA 01845

1565 Main St
Tewksbury, MA 01876
Phone (978) 323-2819

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1558087130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 TURNPIKE ST # 112",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456137",
            "telephone_number": "978-328-0768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762085",
            "telephone_number": "978-328-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENCIA PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-16",
        "status": "A",
        "authorized_official_last_name": "IZZICUPO",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "201-317-9683",
        "authorized_official_credential": "PT, DPT, SCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.