Individual provider Active NPI

Madison Stabile, DPT

  • Physical Therapist
  • Somerville, MA
National Provider Identifier
1780366054
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14093 Issued in CT
Practice address
259 Elm St
Somerville, MA 02144-2950
Phone
(860) 399-6411
NPI assigned
Aug 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 14093 CT Primary

Addresses

Primary practice location

259 Elm St
Somerville, MA 02144-2950

Mailing address

PO Box 322
Boston, MA 02134-0003
Phone (617) 623-6300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204003792 MA Practitioner - Physical Therapist in Private Practice 8921461500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Sports Medicine IncGroup PAC ID 9032163985, 28 clinicians

Practice addresses (Care Compare)

259 Elm St
Suite 204
Somerville, MA 02144-2950
Phone (617) 623-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27606MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Sports Medicine Inc Physical Therapist CurrentSince Sep 27, 2024 Accepting new patients

Locations

259 Elm St
Ste 204
Somerville, MA 02144
Phone (617) 623-6300

14 McGrath Hwy
Somerville, MA 02143
Phone (617) 623-4500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11813/brand/1/csg/1/fhir/r4

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": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1780366054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 322",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021340003",
            "telephone_number": "617-623-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 ELM ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442950",
            "telephone_number": "860-399-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABILE",
        "first_name": "MADISON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-04",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.