Individual provider Active NPI

Jennifer K. Boland, DPT

  • Physical Therapist
  • Worcester, MA
National Provider Identifier
1801011838
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16097 Issued in MA
Practice address
39 Salisbury St
Diversified Staffing Group
Worcester, MA 01609-3160
Phone
(603) 624-9002
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16097 MA Primary

Addresses

Primary practice location

39 Salisbury St
Diversified Staffing Group
Worcester, MA 01609-3160

Mailing address

241 Moosehill Rd
East Walpole, MA 02032-1430
Phone (508) 734-5379

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060413000117 MA Practitioner - Physical Therapist in Private Practice 7416966841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

63 Winthrop St
Suite C1 C2
Taunton, MA 02780-6218
Phone (508) 880-3223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16097MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Physical Therapist CurrentSince Apr 12, 2021 Accepting new patients
Bay State Physical Therapy of Randolph Inc CurrentSince Apr 12, 2021 Accepting new patients

Locations

1 Pearl St
Ste 1700
Brockton, MA 02301
Phone (508) 427-0525

1343 Providence Hwy
Norwood, MA 02062
Phone (781) 702-1339

1054 County St
Somerset, MA 02726
Phone (508) 674-3340

63 Winthrop St
Ste C1C2
Taunton, MA 02780
Phone (508) 822-8514

152 Dean St
Taunton, MA 02780
Phone (508) 824-3872

Organizations & group practices 3

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801011838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 MOOSEHILL RD",
            "city": "EAST WALPOLE",
            "state": "MA",
            "postal_code": "020321430",
            "telephone_number": "508-734-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SALISBURY ST",
            "address_2": "DIVERSIFIED STAFFING GROUP",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016093160",
            "telephone_number": "603-624-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JENNIFER",
        "middle_name": "K.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.