Keith E Callanan, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13381 Issued in MA

Practice address

1519 Central St
Stoughton, MA 02072-4415

Phone

(781) 297-0979

Fax

(781) 297-3703

NPI assigned

Sep 15, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Sports IncGroup PAC ID 3072539337, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Elite Sports, Inc.

  • Physical Therapist
  • Stoughton, MA
  • NPI 1093811408
  Medicare reassignment Care Compare group NPD Authorized official
• Elite Health and Fitness

  • Physical Therapy Clinic/Center
  • Stoughton, MA
  • NPI 1184953390
  NPD (past) Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1902902380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 CENTRAL ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724415",
            "telephone_number": "781-297-0979",
            "fax_number": "781-297-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 CENTRAL ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724415",
            "telephone_number": "781-297-0979",
            "fax_number": "781-297-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLANAN",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "13381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y67872",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Cable, EDD
• Nancy Conant Cable, LICSW
• Marly Daihann Cadet
• Peter Joseph Calkin, D.O.
• Tracy Callahan, PA
• Genevieve Calvo
• Ann M Campanario
• Nicole Campanelli
• Devashree Campbell
• Sonya Campbell, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.