Individual provider Active NPI

Maria Panagiota Shevory, PT, DPT, ATC

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1609393412
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23260 Issued in MA
Practice address
607 Boylston St FL 4
Boston, MA 02116-3604
Phone
(857) 350-4544
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 23260 MA Primary

Addresses

Primary practice location

607 Boylston St FL 4
Boston, MA 02116-3604

Mailing address

63 Bellevue Hill Rd
West Roxbury, MA 02132-2120
Phone (617) 785-0143

Other practice location 1

46 Long Pond Rd
Plymouth, MA 02360-2606
Phone (774) 283-4387

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170907002795 MA Practitioner - Physical Therapist in Private Practice 3375816630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Boston University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Boston UniversityGroup PAC ID 8921070822, 43 clinicians

Practice addresses (Care Compare)

915 Commonwealth Ave
Boston, MA 02215-1394
Phone (617) 358-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Boston University CurrentSince Jul 1, 2021 Accepting new patients
Trustees of Boston University Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Competitive Edge Physical Therapy & Sports Training, LLC Physical Therapist Past Accepting new patients

Locations

915 Commonwealth Ave
Boston, MA 02215
Phone (617) 358-3400

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1609393412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BELLEVUE HILL RD",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322120",
            "telephone_number": "617-785-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BOYLSTON ST FL 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163604",
            "telephone_number": "857-350-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023602606",
            "country_code": "US",
            "telephone_number": "774-283-4387",
            "fax_number": "774-283-4619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEVORY",
        "first_name": "MARIA",
        "middle_name": "PANAGIOTA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23260",
            "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 Jul 17, 2024; 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.