Individual provider Active NPI

Emily Mandara

  • Physical Therapist
  • West Boylston, MA
National Provider Identifier
1710354048
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21826 Issued in MA
Practice address
354 W Boylston St
Suite 111
West Boylston, MA 01583-2373
Phone
(508) 852-3700
Fax
(508) 852-3777
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 21826 MA Primary

Addresses

Primary practice location

354 W Boylston St
Suite 111
West Boylston, MA 01583-2373

Mailing address

354 W Boylston St
Suite 111
West Boylston, MA 01583-2373
Phone (508) 852-3700

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

NPI Registry JSON

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1710354048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 W BOYLSTON ST",
            "address_2": "SUITE 111",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832373",
            "telephone_number": "508-852-3700",
            "fax_number": "508-852-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 W BOYLSTON ST",
            "address_2": "SUITE 111",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832373",
            "telephone_number": "508-852-3700",
            "fax_number": "508-852-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDARA",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.