Active NPI
Jane Davenport Lucas, PT
- Physical Therapist
- Boston, MA
National Provider Identifier
1700896818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4529
- Practice address
- 264 Beacon St
Boston, MA 02116-1236 - Phone
- (617) 266-6621
- Fax
- (617) 266-2115
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 4529 | MA | Primary |
Addresses
Primary practice location
264 Beacon St
Boston, MA 02116-1236
Mailing address
264 Beacon Street
Dba Back Bay Physical Therapy
Boston, MA 02116
Phone (617) 266-6621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101228000474 | MA | Practitioner - Physical Therapist in Private Practice | 0446448922 | Practice locations: Boston, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Northwestern University Feinberg Medical School, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
224 Clarendon St
Suite 21
Boston, MA 02116-3795
Phone (617) 266-6621
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4529 | MA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700896818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 BEACON STREET",
"address_2": "DBA BACK BAY PHYSICAL THERAPY",
"city": "BOSTON",
"state": "MA",
"postal_code": "02116",
"telephone_number": "617-266-6621",
"fax_number": "617-266-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 BEACON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021161236",
"telephone_number": "617-266-6621",
"fax_number": "617-266-2115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JANE",
"middle_name": "DAVENPORT",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "4529",
"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 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.