Individual provider Active NPI

Ashley E Iaconelli, DPT

  • Orthopedic Physical Therapist
  • North Easton, MA
National Provider Identifier
1639300205
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
18750 Issued in MA
Practice address
15 Roche Bros Way
North Easton, MA 02356-1000
Phone
(781) 573-1686
Fax
(781) 573-1696
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 18750 MA Primary

Addresses

Primary practice location

15 Roche Bros Way
North Easton, MA 02356-1000

Mailing address

PO Box 30
Stoughton, MA 02072-0030
Phone (781) 573-1686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000176 MA Practitioner - Physical Therapist in Private Practice 0244386787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saperia Orthopaedics and Sports Medicine IncGroup PAC ID 4486759891, 4 clinicians

Practice addresses (Care Compare)

72 Washington St
Taunton, MA 02780-7410
Phone (508) 824-1824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18750MAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saperia Orthopaedics and Sports Medicine, Inc. CurrentSince Jun 8, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 1, 2019 Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

15 Roche Brothers Way
North Easton, MA 02356
Phone (781) 545-9273

3 Washington St
Ste 200
North Easton, MA 02356
Phone (508) 205-9630

15 Roche Brothers Way
Ste 200
North Easton, MA 02356
Phone (401) 490-1939

72 Washington St
Ste 2600
Taunton, MA 02780
Phone (508) 824-1824

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1639300205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020720030",
            "telephone_number": "781-573-1686",
            "fax_number": "781-573-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ROCHE BROS WAY",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561000",
            "telephone_number": "781-573-1686",
            "fax_number": "781-573-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACONELLI",
        "first_name": "ASHLEY",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "18750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.