Individual provider Active NPI

Abigail Stark, OTR/L

  • Occupational Therapist
  • North Dartmouth, MA
National Provider Identifier
1851116248
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTL15279 Issued in MA
Practice address
375 Faunce Corner Rd Ste C
North Dartmouth, MA 02747-1258
Phone
(774) 425-7906
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTL15279 MA Primary

Addresses

Primary practice location

375 Faunce Corner Rd Ste C
North Dartmouth, MA 02747-1258

Mailing address

703 Granite St Ste 3
Braintree, MA 02184-5350
Phone (781) 807-6138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125004364 MA Practitioner - Occupational Therapist in Private Practice 9739614959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

375 Faunce Corner Rd
Suite C
North Dartmouth, MA 02747-1258
Phone (774) 425-7911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTL15279MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy of Randolph Inc Occupational Therapist CurrentSince Dec 1, 2024 Accepting new patients
Bay State Physical Therapy of Randolph Inc Occupational Therapist CurrentSince Dec 1, 2024 Accepting new patients

Locations

703 Granite St
Ste 3
Braintree, MA 02184

375 Faunce Corner Rd
Ste C
North Dartmouth, MA 02747
Phone (774) 425-7906

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

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": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1851116248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-807-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 FAUNCE CORNER RD STE C",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471258",
            "telephone_number": "774-425-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ABIGAIL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "OTL15279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.