Individual provider Active NPI

Tejasvi Pawar, DPT

  • Physical Therapist
  • Randolph, MA
National Provider Identifier
1649879917
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25227 Issued in MA
Practice address
26 S Main St
Randolph, MA 02368-4821
Phone
(781) 961-9200
Fax
(781) 961-6599
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 25227 MA Primary

Addresses

Primary practice location

26 S Main St
Randolph, MA 02368-4821

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027001321 MA Practitioner - Physical Therapist in Private Practice 6002236395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greendale Physical Therapy LLCGroup PAC ID 9133013691, 36 clinicians

Practice addresses (Care Compare)

280 Boston Tpke
Shrewsbury, MA 01545-2640
Phone (508) 753-7780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25227MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Oct 13, 2020 Accepting new patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Oct 13, 2020 Accepting new patients
Greendale Physical Therapy, LLC Physical Therapist CurrentSince Jul 24, 2023 Accepting new patients

Locations

703 Granite St
Ste 3
Braintree, MA 02184

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

26 S Main St
Randolph, MA 02368
Phone (781) 961-9200

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

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

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

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": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1649879917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684821",
            "telephone_number": "781-961-9200",
            "fax_number": "781-961-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWAR",
        "first_name": "TEJASVI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.