Individual provider Active NPI

Daniel Joy, PT, DPT, CSCS

  • Physical Therapist
  • Brockton, MA
National Provider Identifier
1629434592
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22237 Issued in MA
Practice address
1 Pearl St
Ste 1700
Brockton, MA 02301-2864
Phone
(508) 427-0525
Fax
(774) 223-5017
NPI assigned
Jan 7, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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 22237 MA Primary

Addresses

Primary practice location

1 Pearl St
Ste 1700
Brockton, MA 02301-2864

Mailing address

1 Credit Union Way
FL. 3
Randolph, MA 02368-4633
Phone (781) 961-3370

Other identifiers 2

IdentifierTypeStateIssuer
110114582AOtherMAMASSHEALTH PROVIDER IDENTIFICATION NUMBER
S4003007859OtherMAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22237MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1629434592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY",
            "address_2": "FL. 3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "STE 1700",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-427-0525",
            "fax_number": "774-223-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOY",
        "first_name": "DANIEL",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH PROVIDER IDENTIFICATION NUMBER",
            "identifier": "110114582A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S4003007859",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.