Connor Riley Prendergast, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26369 Issued in MA

Practice address

1 H F Brown Way
Natick, MA 01760-3889

Phone

(508) 647-1633

Fax

(508) 647-1634

NPI assigned

Dec 2, 2022

Last updated

Dec 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jump Start Physical Therapy, IncGroup PAC ID 0042295123, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jump Start Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Natick, MA
  • NPI 1497769483

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1639889470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 H F BROWN WAY",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017603889",
            "telephone_number": "508-647-1633",
            "fax_number": "508-647-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 H F BROWN WAY",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017603889",
            "telephone_number": "508-647-1633",
            "fax_number": "508-647-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "CONNOR",
        "middle_name": "RILEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathaleen A. Porter, M.D.
• Starr Boggs Potts, M.S.W.
• Meg Power
• Precidiag, Inc.
• Premier Dental Associates
• Preservation Physical Therapy and Wellness LLC
• Kaleigh Price
• Margaret Price, LMHC
• Primary Home Healthcare LLC
• Prime Dental Associates, LLC

• Physical Therapist in Natick, MA
• Providers in Natick, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.