Active NPI
Scott David Waugh, PT
- Physical Therapist
- Brookline, MA
National Provider Identifier
1720005655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8158
- Practice address
- 1101 Beacon St
Brookline, MA 02446-5587 - Phone
- (617) 232-6633
- Fax
- (617) 232-6832
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- 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 | 8158 | MA | Primary |
Addresses
Primary practice location
1101 Beacon St
Brookline, MA 02446-5587
Mailing address
62 Damon Rd
Hanover, MA 02339-1131
Phone (787) 871-6659
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8158 | Other | MA | MA PT LISENCE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060424000047 | MA | Practitioner - Physical Therapist in Private Practice | 5799795647 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8158 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720005655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 DAMON RD",
"city": "HANOVER",
"state": "MA",
"postal_code": "023391131",
"telephone_number": "787-871-6659",
"fax_number": "617-232-6832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465587",
"telephone_number": "617-232-6633",
"fax_number": "617-232-6832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAUGH",
"first_name": "SCOTT",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "8158",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA PT LISENCE NUMBER",
"identifier": "8158",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.