Mallory Herrick

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27258 Issued in MA

Practice address

960 William T Morrissey Blvd
Dorchester, MA 02122-3242

Phone

(617) 506-7210

NPI assigned

Nov 17, 2023

Sex

Female

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elliott Physical Therapy, IncGroup PAC ID 9830322585, 60 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 and National Provider Directory roles.

• Elliott Physical Therapy, Inc.

  • Physical Therapist
  • Dorchester, MA
  • NPI 1639591126
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1639944838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WILLIAM T MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 WILLIAM T MORRISSEY BLVD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223242",
            "telephone_number": "617-506-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRICK",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Hernandez, LPN
• Nelsys Luciana Hernandez
• Olga Lizeth Hernandez
• Salaam Imani Hernandez, CERTIFICATION ECD
• Shannon M Hernandez
• Michaele Hicks
• Sheryl Hilliard, LICSW
• William Himelhoch, LICSW
• Rachel Debra Hindin, MD
• Melissa A Hinds

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.