Mary Peyton Provenzano, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7312 Issued in MA

Practice address

160 Route 137
Harwich, MA 02645-1316

Phone

(774) 237-0832

Fax

(774) 408-7164

NPI assigned

Jul 8, 2013

Last updated

Jul 8, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orthopedic & Sports Physical Therapy of Cape Cod LLC

  • Physical Therapy Clinic/Center
  • Harwich, MA
  • NPI 1881903615
  NPD (past)
• Orthopedic and Sports Physical Therapy

  • Physical Therapy Clinic/Center
  • Harwich, MA
  • NPI 1992146849
  NPD (past)

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1871934729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 LOVE LN",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931114",
            "telephone_number": "617-974-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ROUTE 137",
            "city": "HARWICH",
            "state": "MA",
            "postal_code": "026451316",
            "telephone_number": "774-237-0832",
            "fax_number": "774-408-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "MARY",
        "middle_name": "PEYTON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "7312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pleasant Lake Cancer Center LLC
• Pleasant Lake Management Company PC (Pleasant Lake Medical Offices)
• Pleasant Lake Medical Center LLC
• Pleasant Lake Urgent Care LLC (Pleasant lake urgent care)
• Prism Medical Associates,LLC
• Robert E. Reed Jr., PT
• Marilyn Hyland Reedy, LMHC
• Regal Care at Harwich LLC
• Richard a. Weiler, Jr., D.D.S. and Associates, P.C.
• Deborah McGrath Riley, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.