Individual provider Active NPI

Jennifer Kelly Plourde, PT, DPT

  • Physical Therapist
  • Weymouth, MA
National Provider Identifier
1619791027
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18458 Issued in MA
Practice address
51 Performance Dr
Weymouth, MA 02189-3141
Phone
(781) 682-0530
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 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 18458 MA Primary

Addresses

Primary practice location

51 Performance Dr
Weymouth, MA 02189-3141

Mailing address

1686 Washington St
Canton, MA 02021-1640
Phone (781) 571-1051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241226001944 MA Practitioner - Physical Therapist in Private Practice 0648707976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

51 Performance Dr
Weymouth, MA 02189-3141
Phone (781) 682-0550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18458MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Atrius Health, Inc. Physical Therapist CurrentSince Dec 30, 2024 Accepting new patients
Atrius Health, Inc. Physical Therapist Current Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

51 Performance Dr
Weymouth, MA 02189
Phone (781) 337-5555

Interoperability endpoints

  • Direct secure messaging: jplourdept392169@direct.atrius.masshiway.net

Organizations & group practices 3

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": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1619791027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 WASHINGTON ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211640",
            "telephone_number": "781-571-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PERFORMANCE DR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893141",
            "telephone_number": "781-682-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOURDE",
        "first_name": "JENNIFER",
        "middle_name": "KELLY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.