Individual provider Active NPI

Brian Dupuis

  • Physical Therapy Assistant
  • Tewksbury, MA
National Provider Identifier
1881402402
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
7990 Issued in MA
Practice address
1624 Main St
Tewksbury, MA 01876-2261
Phone
(978) 547-5675
NPI assigned
Dec 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 7990 MA Primary

Addresses

Primary practice location

1624 Main St
Tewksbury, MA 01876-2261

Mailing address

137 Hoyt Ave
Lowell, MA 01852-4228
Phone (978) 621-6960

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7990MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1735344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1881402402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HOYT AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524228",
            "telephone_number": "978-621-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018762261",
            "telephone_number": "978-547-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPUIS",
        "first_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-28",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "7990",
            "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 Dec 28, 2024; 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.