Individual provider Active NPI

Lisa Brown, PT, DPT, NCS,

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1760769830
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9304 Issued in MA
Practice address
635 Commonwealth Ave
Boston, MA 02215-1605
Phone
(617) 353-2304
Fax
(617) 353-9463
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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 9304 MA Primary

Addresses

Primary practice location

635 Commonwealth Ave
Boston, MA 02215-1605

Mailing address

10 Prospect St
Upton, MA 01568-1305
Phone (617) 353-2304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130109000313 MA Practitioner - Physical Therapist in Private Practice 3577716216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9304MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Jun 9, 2023 Accepting new patients

Locations

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1760769830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PROSPECT ST",
            "city": "UPTON",
            "state": "MA",
            "postal_code": "015681305",
            "telephone_number": "617-353-2304",
            "fax_number": "617-353-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 COMMONWEALTH AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151605",
            "telephone_number": "617-353-2304",
            "fax_number": "617-353-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, NCS,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "9304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.