Active NPI
Tara Stanczyk-McCrystal, PT
- Physical Therapist
- East Boston, MA
National Provider Identifier
1700106069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18991
- Practice address
- 130 Condor St
East Boston, MA 02128-1305 - Phone
- (617) 569-6560
- NPI assigned
- Jun 9, 2010
- 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 | 18991 | MA | Primary |
Addresses
Primary practice location
130 Condor St
East Boston, MA 02128-1305
Mailing address
18 Cedar St
North Reading, MA 01864-2702
Phone (203) 430-1475
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18991 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1700106069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 CEDAR ST",
"city": "NORTH READING",
"state": "MA",
"postal_code": "018642702",
"telephone_number": "203-430-1475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CONDOR ST",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021281305",
"telephone_number": "617-569-6560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANCZYK-MCCRYSTAL",
"first_name": "TARA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-09",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "18991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.