Individual provider Active NPI

Alex D Fontaine, DPT

  • Physical Therapist
  • Belchertown, MA
National Provider Identifier
1710620646
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL25757 Issued in MA
Practice address
25 Bridge St
Belchertown, MA 01007-8909
Phone
(413) 323-1020
NPI assigned
Apr 19, 2022
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 PTL25757 MA Primary

Addresses

Primary practice location

25 Bridge St
Belchertown, MA 01007-8909

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426000237 MA Practitioner - Physical Therapist in Private Practice 7214324086 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Moody St
Ludlow, MA 01056-1228
Phone (714) 785-4666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL25757MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Jul 1, 2024 Accepting new patients
Northeast Orthopaedic Alliance PLLC CurrentSince Jul 1, 2024 Accepting new patients
New England Orthopedic Surgeons CurrentSince Dec 5, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist Current Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients
New England Orthopedic Surgeons Physical Therapist CurrentSince Dec 5, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

25 Bridge St
Belchertown, MA 01007
Phone (413) 323-1020

265 Benton Dr
Ste 101
East Longmeadow, MA 01028
Phone (714) 785-4666

1 Moody St
Ludlow, MA 01056
Phone (413) 583-2274

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1710620646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BRIDGE ST",
            "city": "BELCHERTOWN",
            "state": "MA",
            "postal_code": "010078909",
            "telephone_number": "413-323-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTAINE",
        "first_name": "ALEX",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL25757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belchertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.