Individual provider Active NPI

Melissa Davalos

  • Physical Therapist
  • Marlborough, MA
National Provider Identifier
1760264907
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18488 Issued in MA
Practice address
720 Boston Post Rd E
Marlborough, MA 01752-3766
Phone
(508) 597-0245
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 18488 MA Primary

Addresses

Primary practice location

720 Boston Post Rd E
Marlborough, MA 01752-3766

Mailing address

12 Summer LN
Framingham, MA 01701-7908
Phone (508) 963-6666

Other practice location 1

115 Lincoln St
Framingham, MA 01702-6342
Phone (508) 383-1070 ext. 1

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705001064 MA Practitioner - Physical Therapist in Private Practice 0648714311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

720 Boston Post Rd E
Marlborough, MA 01752-3766
Phone 97887798783766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18488MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physical Therapy & Wellness, Inc Physical Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

720 Boston Post Rd E
Marlborough, MA 01752
Phone (508) 485-3791

144 Turnpike Rd
Ste 220
Southborough, MA 01772
Phone (508) 303-3020

Organizations & group practices 1

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": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1760264907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SUMMER LN",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017017908",
            "telephone_number": "508-963-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 BOSTON POST RD E",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523766",
            "telephone_number": "508-597-0245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017026342",
            "country_code": "US",
            "telephone_number": "508-383-1070 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVALOS",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "18488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.