Organization Active NPI

Victory Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Brighton, MA
National Provider Identifier
1588890453
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
VICTORY PHYSICAL THERAPY, INC.
Practice address
35 Soldiers Field PL
Brighton, MA 02135-1103
Phone
(617) 549-2640
NPI assigned
Jun 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Victoria Luzarraga, P.T.
Title
President
Phone
(617) 549-2640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

35 Soldiers Field PL
Brighton, MA 02135-1103

Mailing address

10 Country Corners Rd
Wayland, MA 01778-3606
Phone (617) 549-2640

Other identifiers 1

IdentifierTypeStateIssuer
0011232OtherMAMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1588890453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COUNTRY CORNERS RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017783606",
            "telephone_number": "617-549-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SOLDIERS FIELD PL",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351103",
            "telephone_number": "617-549-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "LUZARRAGA",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-549-2640",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0011232",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.