Individual provider Active NPI

Michelle De Leon Dennie, PT

  • Physical Therapist
  • Woburn, MA
National Provider Identifier
1861093791
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
EL12691 Issued in NH
Practice address
400 Tradecenter Ofc 5864
Woburn, MA 01801-7452
Phone
(603) 880-0448
NPI assigned
Nov 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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 EL12691 NH Primary

Addresses

Primary practice location

400 Tradecenter Ofc 5864
Woburn, MA 01801-7452

Mailing address

522 Amherst St Ste 23
Nashua, NH 03063-1019
Phone (603) 880-0448

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

LicenseStateTypeSpecialty
EL12691NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cpte Senior Therapy Services Inc Physical Therapist CurrentSince Oct 1, 2023 Accepting new patients
Omega Sports Rehabilitation, Inc. Physical Therapist CurrentSince Dec 1, 2014 Accepting new patients
Central Occupational Medicine Providers Ontario Inc Past Accepting new patients

Locations

14901 National Ave
Ste 102
Los Gatos, CA 95032
Phone (408) 358-3631

730 Empey Way
San Jose, CA 95128
Phone (408) 275-1500

400 Tradecenter
Ofc 5864
Woburn, MA 01801
Phone (603) 484-4070

522 Amherst St
Ste 23
Nashua, NH 03063
Phone (603) 484-4070

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1861093791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 AMHERST ST STE 23",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631019",
            "telephone_number": "603-880-0448",
            "fax_number": "603-881-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TRADECENTER OFC 5864",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018017452",
            "telephone_number": "603-880-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIE",
        "first_name": "MICHELLE",
        "middle_name": "DE LEON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "EL12691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.