Individual provider Active NPI

Erin R Botelho, PT

  • Physical Therapist
  • Pawtucket, RI
National Provider Identifier
1740370535
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT02460 Issued in RI
Practice address
21 Division St
Pawtucket, RI 02860-5301
Phone
(401) 726-7100
Fax
(401) 722-9386
NPI assigned
Oct 13, 2006
Last updated
Dec 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17214 MA
Physical Therapist 225100000X PT02460 RI Primary

Addresses

Primary practice location

21 Division St
Pawtucket, RI 02860-5301

Mailing address

4 Richmond SQ Ste 200
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050622000150 MA Practitioner - Physical Therapist in Private Practice 6709821614 Reassigns benefits to 2 organizations
I20160524000994 RI Practitioner - Physical Therapist in Private Practice 6709821614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians
Orthopedic and Sports Physical Therapy IncGroup PAC ID 3072593300, 8 clinicians

Practice addresses (Care Compare)

1295 Fall River Ave
Seekonk, MA 02771-5931
Phone (508) 231-5944

21 Division St
Pawtucket, RI 02860-5301
Phone (401) 726-7100

320 Main St
Brockton, MA 02301-5340
Phone (508) 584-0800

650 Plymouth St
East Bridgewater, MA 02333-2054
Phone (508) 378-4035

Merit-based Incentive Payment System (MIPS)

Final score
80.9 of 100Reported as group
Quality
79.21
Improvement activities
40
Cost
74.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT02460RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Mar 14, 2016 Accepting new patients
Orthopedic & Sports Physical Therapy Inc Physical Therapist CurrentSince Jan 1, 2013 Accepting new patients
Orthopedic & Sports Physical Therapy , Inc Physical Therapist CurrentSince Jan 1, 2013 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Mar 14, 2016 Accepting new patients

Locations

1395 Commerce Way
Ste 112
Attleboro, MA 02703
Phone (508) 455-5740

320 Main St
Brockton, MA 02301
Phone (508) 583-2155

650 Plymouth St
East Bridgewtr, MA 02333
Phone (508) 378-4035

1295 Fall River Ave
Seekonk, MA 02771
Phone (508) 231-5944

21 Division St
Pawtucket, RI 02860

4 Richmond Sq
Ste 200
Providence, RI 02906

41 Sanderson Rd
Ste 101
Smithfield, RI 02917
Phone (401) 349-4540

91 Main St
Ste 122
Warren, RI 02885
Phone (401) 289-2999

Organizations & group practices 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1740370535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ STE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DIVISION ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605301",
            "telephone_number": "401-726-7100",
            "fax_number": "401-722-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELHO",
        "first_name": "ERIN",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17214",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.