Kimberly Mace, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16907 Issued in MA

Practice address

260 Tremont St
Box 120008
Boston, MA 02116-5603

Phone

(617) 636-5175

Fax

(617) 636-5176

NPI assigned

Nov 10, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ortho & Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Boston, MA
  • NPI 1700864139
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679554208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "address_2": "BOX 120008",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603",
            "telephone_number": "617-636-5175",
            "fax_number": "617-636-5176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TREMONT ST",
            "address_2": "BOX 120008",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165603",
            "telephone_number": "617-636-5175",
            "fax_number": "617-636-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACE",
        "first_name": "KIMBERLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Y69467",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trevor Macdonald
• Gordon Macdougall
• Katelyn Maiyumi Macdougall, LICSW
• Shannon Taylor Macdowell, AGPCNP-BC, RN
• Kathleen Macduffie, MSW, LCSW
• Kimberly L Mace, MS, ATC
• Ryan Andrew Mace, PHD
• Irene C Maceachern, NP
• Renata Macedo
• Christina L Macenski, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.