Individual provider Active NPI

Daniel Munkley III, DPT

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1558754614
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21594 Issued in MA
Practice address
1350 Tremont St
Boston, MA 02120-3447
Phone
(617) 267-3773
Fax
(617) 602-1010
NPI assigned
Mar 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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 21594 MA Primary

Addresses

Primary practice location

1350 Tremont St
Boston, MA 02120-3447

Mailing address

1 Credit Union Way
FL. 3
Randolph, MA 02368-4633
Phone (781) 961-3370

Other identifiers 2

IdentifierTypeStateIssuer
110110059AMedicaidMA
S400252881OtherMAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1558754614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY",
            "address_2": "FL. 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021203447",
            "telephone_number": "617-267-3773",
            "fax_number": "617-602-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNKLEY",
        "first_name": "DANIEL",
        "name_suffix": "III",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110110059A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S400252881",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.