NPIMap

Organization Active NPI

Eastway Wellness LLC

  • Physical Therapist
  • Norwood, MA
National Provider Identifier
1790295566
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22813 Issued in MA
Legal business name
EASTWAY WELLNESS LLC
Practice address
11 Vanderbilt Ave
Norwood, MA 02062-5056
Phone
(781) 688-0138
Fax
(781) 269-5613
NPI assigned
Oct 6, 2017
Organization subpart
Yes
Parent organization
EASTWAY WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yi Luo, LAC
Title
Manager
Phone
(781) 688-0138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 22813 MA Primary

Addresses

Primary practice location

11 Vanderbilt Ave
Norwood, MA 02062-5056

Mailing address

11 Vanderbilt Ave
210
Norwood, MA 02062-5056
Phone (781) 688-0138

Other practice location 1

360B Tremont St
Boston, MA 02116-5538
Phone (857) 233-2575

Other identifiers 1

IdentifierTypeStateIssuer
22813OtherMAPHYSICAL THERAPY

National Provider Directory

National Provider Directory
Tax ID family
Eastway Wellness LLC3 organizations share this tax ID, including this one
Part of
Eastway Wellness LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Lincoln St
Ste 302
Boston, MA 02111
Phone (781) 688-0138

11 Vanderbilt Ave
Ste 210
Norwood, MA 02062
Phone (781) 688-0138

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1790295566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 VANDERBILT AVE",
            "address_2": "210",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625056",
            "telephone_number": "781-688-0138",
            "fax_number": "781-269-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 VANDERBILT AVE",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625056",
            "telephone_number": "781-688-0138",
            "fax_number": "781-269-5613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360B Tremont St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021165538",
            "country_code": "US",
            "telephone_number": "857-233-2575",
            "fax_number": "781-269-5613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTWAY WELLNESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTWAY WELLNESS LLC",
        "enumeration_date": "2017-10-06",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "LUO",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "781-688-0138",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "22813",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.