NPIMap

Organization Active NPI

Advance Orthopedic & Sports Therapy

  • Physical Therapist
  • Tewksbury, MA
National Provider Identifier
1871570176
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCE ORTHOPEDIC & SPORTS THERAPY
Practice address
600 Clark Rd
Tewksbury, MA 01876
Phone
(978) 452-3453
Fax
(978) 452-2652
NPI assigned
Dec 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Authorized official

Name
Mitchell Guttentag, PTNPI 1902879208
Title
Clinic Owner
Phone
(978) 452-3453

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

600 Clark Rd
Tewksbury, MA 01876

Mailing address

600 Clark Rd
Tewksbury, MA 01876
Phone (978) 452-3453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031118000397 MA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022922624 Receives reassigned benefits from 10 practitioners
Practice locations: Tewksbury, MA

National Provider Directory

National Provider Directory
Tax ID family
Advance Orthopedic and Sports Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1871570176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-452-3453",
            "fax_number": "978-452-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "01876",
            "telephone_number": "978-452-3453",
            "fax_number": "978-452-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE ORTHOPEDIC & SPORTS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "GUTTENTAG",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "978-452-3453",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.