Individual provider Active NPI

Pablo Maldonado Pinuer

  • Physical Therapist
  • Worcester, MA
National Provider Identifier
1639631211
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20832 Issued in MA
Practice address
120 Gold Star Blvd
Worcester, MA 01606-2825
Phone
(508) 853-4590
Fax
(949) 756-4811
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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 20832 MA Primary

Addresses

Primary practice location

120 Gold Star Blvd
Worcester, MA 01606-2825

Mailing address

280 Boston Tpke
Shrewsbury, MA 01545-2640
Phone (508) 853-4590

Other practice location 1

145 Church St
Clinton, MA 01510-2560
Phone (508) 853-4590

Other practice location 2

280 Boston Tpke
Shrewsbury, MA 01545-2640
Phone (508) 853-4590

Other practice location 3

7650 Currell Blvd Ste 260
Woodbury, MN 55125-8209
Phone (952) 345-3000

Other practice location 4

4801 W 81st St Ste 112
Bloomington, MN 55437-1111
Phone (952) 913-2907

Other practice location 5

162 Cobblestone Ln
Burnsville, MN 55337-4578
Phone (952) 345-3000

Other practice location 6

1630 101st Ave NE Ste 160
Blaine, MN 55449-3403
Phone (952) 345-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190813000620 MA Practitioner - Physical Therapist in Private Practice 7618204702 Reassigns benefits to 1 organization
I20250414002212 MN Practitioner - Physical Therapist in Private Practice 7618204702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Dizzy and Balance Center,LTD.Group PAC ID 7315983954, 29 clinicians

Practice addresses (Care Compare)

4801 W 81St St
Suite 112
Bloomington, MN 55437-1111
Phone (952) 345-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20832MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
National Dizzy & Balance Center,LTD. Physical Therapist CurrentSince May 1, 2025 Accepting new patients
Greendale Physical Therapy, LLC Physical Therapist CurrentSince Jun 3, 2019 Accepting new patients
Lifespark Medical Group, PA PastSince May 1, 2025 Accepting new patients

Locations

280 Boston Tpke
Shrewsbury, MA 01545
Phone (508) 753-7780

120 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-5000

1630 101st Ave NE
Ste 160
Blaine, MN 55449
Phone (763) 786-6900

162 Cobblestone Ln
Burnsville, MN 55337
Phone (952) 345-3000

4801 W 81st St
Ste 112
Minneapolis, MN 55437
Phone (952) 345-3000

7650 Currell Blvd
Ste 260
Woodbury, MN 55125
Phone (952) 345-3000

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1639631211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BOSTON TPKE",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452640",
            "telephone_number": "508-853-4590",
            "fax_number": "949-756-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GOLD STAR BLVD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062825",
            "telephone_number": "508-853-4590",
            "fax_number": "949-756-4811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Church St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MA",
            "postal_code": "015102560",
            "country_code": "US",
            "telephone_number": "508-853-4590",
            "fax_number": "949-756-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Boston Tpke",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015452640",
            "country_code": "US",
            "telephone_number": "508-853-4590",
            "fax_number": "949-756-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7650 Currell Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551258209",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 W 81st St Ste 112",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554371111",
            "country_code": "US",
            "telephone_number": "952-913-2907",
            "fax_number": "523-456-7899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 Cobblestone Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374578",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 101st Ave NE Ste 160",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554493403",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO PINUER",
        "first_name": "PABLO",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.