NPIMap

Organization Active NPI

Soma Physical Therapy and Rehab, LLC

  • Physical Therapy Clinic/Center
  • Needham, MA
National Provider Identifier
1730477456
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
901 Issued in MA
Legal business name
SOMA PHYSICAL THERAPY AND REHAB, LLC
Practice address
220 Reservoir St
Suite 32
Needham, MA 02494-3149
Phone
(781) 400-1236
NPI assigned
Jul 15, 2011
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Dr. James Ray Ruetenik, P.T.NPI 1386743474
Title
Ocs
Phone
(781) 400-1236

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 901 MA Primary

Addresses

Primary practice location

220 Reservoir St
Suite 32
Needham, MA 02494-3149

Mailing address

220 Reservoir St
Suite 32
Needham, MA 02494-3149
Phone (781) 400-1236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111115000549 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5991979619 Receives reassigned benefits from 3 practitioners
Practice locations: Needham, MA

National Provider Directory

National Provider Directory

Locations

43 Charles St
Needham, MA 02494
Phone (781) 350-5889

220 Reservoir St
Ste 32
Needham Heights, MA 02494
Phone (781) 400-1236

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1730477456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RESERVOIR ST",
            "address_2": "SUITE 32",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943149",
            "telephone_number": "781-400-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RESERVOIR ST",
            "address_2": "SUITE 32",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943149",
            "telephone_number": "781-400-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA PHYSICAL THERAPY AND REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-15",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "RUETENIK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OCS",
        "authorized_official_telephone_number": "781-400-1236",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MA",
            "license": "901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.

Verify at the official NPI Registry.