Active NPI
Tamara Souza, DPT
- Physical Therapist
- Randolph, MA
National Provider Identifier
1780976241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19199
- Practice address
- 63 S Main St
Randolph, MA 02368-4862 - Phone
- (781) 961-9200
- Fax
- (781) 961-6599
- NPI assigned
- May 3, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 19199 | MA | Primary |
Addresses
Primary practice location
63 S Main St
Randolph, MA 02368-4862
Mailing address
535 S Main St
Randolph, MA 02368-5261
Phone (781) 961-3370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19199 | Other | MA | PT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19199 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1780976241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 S MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023685261",
"telephone_number": "781-961-3370",
"fax_number": "781-767-7531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 S MAIN ST",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023684862",
"telephone_number": "781-961-9200",
"fax_number": "781-961-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUZA",
"first_name": "TAMARA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-03",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "19199",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "19199",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.