Active NPI
Kaitlyn Roseberry, DPT
- Physical Therapist
- Boston, MA
National Provider Identifier
1689392292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26383
- Practice address
- 1290 Tremont St FL 5
Boston, MA 02120-3432 - Phone
- (617) 989-3100
- Fax
- (617) 858-2494
- NPI assigned
- Aug 19, 2022
- Sex
- Female
- 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 | 26383 | MA | Primary |
Addresses
Primary practice location
1290 Tremont St FL 5
Boston, MA 02120-3432
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
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26383 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660867200000",
"number": "1689392292",
"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": "1290 TREMONT ST FL 5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203432",
"telephone_number": "617-989-3100",
"fax_number": "617-858-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEBERRY",
"first_name": "KAITLYN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "26383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.