NPIMap

Organization Active NPI

Blackstone Valley Physical Therapy Services Inc

  • Physical Therapist
  • Whitinsville, MA
National Provider Identifier
1598766198
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8 Issued in MA
Legal business name
BLACKSTONE VALLEY PHYSICAL THERAPY SERVICES INC
Practice address
670 Linwood Ave
Suite 2
Whitinsville, MA 01588-2068
Phone
(508) 234-7544
Fax
(508) 234-8002
NPI assigned
Aug 4, 2005
Last updated
Mar 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Mr. Eric M. Connolly, PTNPI 1700887999
Title
President
Phone
(508) 234-7544

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 8 MA Primary

Addresses

Primary practice location

670 Linwood Ave
Suite 2
Whitinsville, MA 01588-2068

Mailing address

670 Linwood Ave
Suite 2
Whitinsville, MA 01588-2068
Phone (508) 234-7544

Other identifiers 5

IdentifierTypeStateIssuer
626572OtherMAHARVARD PILGRIM
64-00083OtherMAUNITED HEALTHCARE
60156OtherMAFIRST HEALTH
603778OtherMATUFTS
Y65612OtherMABLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121207000301 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1153217138 Receives reassigned benefits from 11 practitioners
Practice locations: Whitinsville, MA

National Provider Directory

National Provider Directory

Locations

670 Linwood Ave
Ste 2
Whitinsville, MA 01588
Phone (508) 234-7544

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1598766198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LINWOOD AVE",
            "address_2": "SUITE 2",
            "city": "WHITINSVILLE",
            "state": "MA",
            "postal_code": "015882068",
            "telephone_number": "508-234-7544",
            "fax_number": "508-234-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LINWOOD AVE",
            "address_2": "SUITE 2",
            "city": "WHITINSVILLE",
            "state": "MA",
            "postal_code": "015882068",
            "telephone_number": "508-234-7544",
            "fax_number": "508-234-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE VALLEY PHYSICAL THERAPY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-04",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-234-7544",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "626572",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "64-00083",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "60156",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "603778",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y65612",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitinsville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.