Active NPI
Diane Susan Naczas, MSPT
- Physical Therapy Clinic/Center
- Boston, MA
National Provider Identifier
1568100485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 8785
- Practice address
- 101 Arch St
Boston, MA 02110-1130 - Phone
- (212) 287-4257
- NPI assigned
- May 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 8785 | MA | Primary |
Addresses
Primary practice location
101 Arch St
Boston, MA 02110-1130
Mailing address
50 Victoria Ave
Reading, MA 01867-3452
Phone (351) 201-9028
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8785 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1568100485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 VICTORIA AVE",
"city": "READING",
"state": "MA",
"postal_code": "018673452",
"telephone_number": "351-201-9028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 ARCH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021101130",
"telephone_number": "212-287-4257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACZAS",
"first_name": "DIANE",
"middle_name": "SUSAN",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-20",
"last_updated": "2022-05-20",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "MA",
"license": "8785",
"primary": true
}
],
"identifiers": [],
"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 May 20, 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.