Individual provider Active NPI

Nicholas Stauros Liatsos, PT

  • Specialist
  • East Greenwich, RI
National Provider Identifier
1699867671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT02026 Issued in RI
Practice address
99 Frenchtown Rd
East Greenwich, RI 02818-1802
Phone
(401) 884-6456
Fax
(401) 884-3210
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT02026 RI Primary

Addresses

Primary practice location

99 Frenchtown Rd
East Greenwich, RI 02818-1802

Mailing address

99 Frenchtown Rd
East Greenwich, RI 02818-1802
Phone (401) 884-6456

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000602 MA Practitioner - Physical Therapist in Private Practice 5799784260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Boston St
Suite 10
Lynn, MA 01904-2540
Phone (781) 598-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT02026RIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Physical Therapy Inc CurrentSince Jun 25, 2007 Accepting new patients

Locations

30 Boston St
Ste 10
Lynn, MA 01904
Phone (781) 598-5900

Organizations & group practices 1

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699867671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 FRENCHTOWN RD",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181802",
            "telephone_number": "401-884-6456",
            "fax_number": "401-884-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 FRENCHTOWN RD",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028181802",
            "telephone_number": "401-884-6456",
            "fax_number": "401-884-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIATSOS",
        "first_name": "NICHOLAS",
        "middle_name": "STAUROS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "RI",
            "license": "PT02026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

  • 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.
  • 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.