Individual provider Active NPI

Kerry Fogarty, PT

  • Physical Therapist
  • Scituate, MA
National Provider Identifier
1841341245
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15449 Issued in MA
Practice address
3 Mill Wharf PLZ Ste N11
Scituate, MA 02066-1379
Phone
(781) 783-5373
Fax
(781) 987-9267
NPI assigned
Jan 15, 2007
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 15449 MA Primary

Addresses

Primary practice location

3 Mill Wharf PLZ Ste N11
Scituate, MA 02066-1379

Mailing address

3 Mill Wharf PLZ Ste N11
Scituate, MA 02066-1379
Phone (781) 783-5373

Other identifiers 1

IdentifierTypeStateIssuer
110085865AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000268 MA Practitioner - Physical Therapist in Private Practice 2860400108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3 Mill Wharf PLZ
Suite N11
Scituate, MA 02066-1379
Phone (781) 783-5373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15449MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Physical Therapy LLC Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Bay State Physical Therapy of Randolph Inc CurrentSince Feb 13, 2006 Accepting new patients
J.B. Rehabilitation Associates, Inc Physical Therapist PastSince May 11, 1999 Accepting new patients

Locations

703 Granite St
Fl 3
Braintree, MA 02184

703 Granite St
Ste 300
Braintree, MA 02184
Phone (781) 807-6138

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

1 Credit Union Way
Fl 3
Randolph, MA 02368

3 Mill Wharf Plz
Ste N11
Scituate, MA 02066
Phone (781) 545-1200

386 W Broadway
Fl 1
South Boston, MA 02127
Phone (617) 752-4672

Organizations & group practices 4

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1841341245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MILL WHARF PLZ STE N11",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020661379",
            "telephone_number": "781-783-5373",
            "fax_number": "781-987-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MILL WHARF PLZ STE N11",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020661379",
            "telephone_number": "781-783-5373",
            "fax_number": "781-987-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "KERRY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085865A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scituate, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.