Active NPI
Jennifer Kelly Plourde, PT, DPT
- Physical Therapist
- Weymouth, MA
National Provider Identifier
1619791027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18458
- 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
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 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18458 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrius Health, Inc. | Current | Accepting new patients | |
| Atrius Health, Inc. | Physical Therapist | Current | 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
- 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.
-
- Internal Medicine Physician
- Dedham, MA
- NPI 1306231519
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.