Individual provider Active NPI

Jennifer Ann Raymond, DPT

  • Physical Therapist
  • Leominster, MA
National Provider Identifier
1740525625
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20112 Issued in MA
Practice address
225 New Lancaster Rd
Leominster, MA 01453
Phone
(978) 840-1900
Fax
(789) 840-1263
NPI assigned
Dec 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 20112 MA Primary

Addresses

Primary practice location

225 New Lancaster Rd
Leominster, MA 01453

Mailing address

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (978) 840-1900

Other practice location 1

145 Church St
Clinton, MA 01510-2560
Phone (978) 598-3155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000651 MA Practitioner - Physical Therapist in Private Practice 6608016605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (978) 840-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20112MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Physical Therapist CurrentSince Jul 22, 2019 Accepting new patients
Reliant Medical Group, Inc CurrentSince Jul 22, 2019 Accepting new patients
Greendale Physical Therapy, LLC Physical Therapist CurrentSince Jul 1, 2015 Accepting new patients
Physical Therapy Innovations, Inc Physical Therapist PastSince Apr 17, 2002 Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

280 Boston Tpke
Shrewsbury, MA 01545
Phone (508) 753-7780

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: jennifer.raymond.npi1740525625.reliant@direct.optumcare.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1740525625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "978-840-1900",
            "fax_number": "789-840-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-840-1900",
            "fax_number": "789-840-1263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Church St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MA",
            "postal_code": "015102560",
            "country_code": "US",
            "telephone_number": "978-598-3155",
            "fax_number": "978-365-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.