Individual provider Active NPI

Connor Lockyer

  • Physical Therapist
  • Dorchester, MA
National Provider Identifier
1558149245
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26993 Issued in MA
Practice address
960 William T Morrissey Blvd
Dorchester, MA 02122-3242
Phone
(617) 506-7210
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 26993 MA Primary

Addresses

Primary practice location

960 William T Morrissey Blvd
Dorchester, MA 02122-3242

Mailing address

960 William T Morrissey Blvd
Dorchester, MA 02122-3242
Phone (617) 506-7210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230929002684 MA Practitioner - Physical Therapist in Private Practice 8628422276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

960 William T Morrissey Blvd
Dorchester, MA 02122-3206
Phone (617) 688-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott Physical Therapy, Inc. Physical Therapist CurrentSince Aug 19, 2023 Accepting new patients

Locations

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

475 Adams St
Milton, MA 02186
Phone (617) 506-7210

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1558149245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WILLIAM T MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 WILLIAM T MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKYER",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.