Active NPI
Jacqueline Defreitas, DPT
- Physical Therapist
- Norwell, MA
National Provider Identifier
1841580404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19090
- Practice address
- 99 Longwater Cir
Ste 201
Norwell, MA 02061-1643 - Phone
- (781) 347-4686
- Fax
- (781) 986-0991
- NPI assigned
- Apr 15, 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 | 19090 | MA | Primary |
Addresses
Primary practice location
99 Longwater Cir
Ste 201
Norwell, MA 02061-1643
Mailing address
99 Longwater Cir
Ste 201
Norwell, MA 02061-1643
Phone (781) 347-4686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19090 | 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 |
|---|---|---|---|
| 19090 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495411200000",
"number": "1841580404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 LONGWATER CIR",
"address_2": "STE 201",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611643",
"telephone_number": "781-347-4686",
"fax_number": "781-986-0991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 LONGWATER CIR",
"address_2": "STE 201",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611643",
"telephone_number": "781-347-4686",
"fax_number": "781-986-0991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFREITAS",
"first_name": "JACQUELINE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-15",
"last_updated": "2017-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "19090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "19090",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.