Active NPI
Raymond Dustin Zolman, DPT
- Physical Therapist
- Medford, MA
National Provider Identifier
1649774928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 23498
- Practice address
- 4110 Mystic Valley Pkwy Ste 12
Medford, MA 02155-6931 - Phone
- (781) 960-6030
- Fax
- (781) 350-3060
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 23498 | MA | Primary |
Addresses
Primary practice location
4110 Mystic Valley Pkwy Ste 12
Medford, MA 02155-6931
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23498 | MA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bioperformance Physical Therapy | Current | Accepting new patients | |
| Carl Gustafson LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- North Reading, MA
- NPI 1275146383
-
dba Sports and Physical Therapy Associates
- Physical Therapist
- Wellesley, MA
- NPI 1356366082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1649774928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 MYSTIC VALLEY PKWY STE 12",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021556931",
"telephone_number": "781-960-6030",
"fax_number": "781-350-3060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOLMAN",
"first_name": "RAYMOND",
"middle_name": "DUSTIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "23498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.