Jack Long, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23177 Issued in MA

Practice address

356 Third St
Cambridge, MA 02142-1111

Phone

(617) 714-5402

Fax

(844) 912-8604

NPI assigned

Aug 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jack Doucette-Long Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Boston University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians

Joint Ventures Physical Therapy IncGroup PAC ID 2163474560, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Joint Ventures Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Boston, MA
  • NPI 1083667901

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Silver Fern Practice, LLC

  • Physical Therapist
  • Providence, RI
  • NPI 1851472914

  MA

  Medicare reassignment Care Compare group NPD
• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment NPD
• Joint Ventures Physical Therapy, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cambridge, MA
  • NPI 1972149805
  NPD
• Silver Fern Practice, LLC

  • Physical Therapist
  • Smithfield, RI
  • NPI 1013583426
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1861918534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 THIRD ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021421111",
            "telephone_number": "617-714-5402",
            "fax_number": "844-912-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "23177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "DOUCETTE-LONG",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarai C Logue, LICSW
• Carlos Alberto Lohmann, MD
• Mary S Lombard
• Mackenzie Lombardi, RDN, LDN
• Jennifer Lones, RN
• Kai Long, M.S. SLP CCC
• Maryann Long, CNM
• Longfellow Primary Care, PC
• Anna Longo, RN
• Longwood Academic Physicians, LLC

• Physical Therapist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.