Active NPI
Jared S Lewis, DPT
- Physical Therapist
- Waltham, MA
National Provider Identifier
1912295650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19572
- Practice address
- 840 Winter St
Attn: Pro Sports Therapy
Waltham, MA 02451-1433 - Phone
- (781) 487-9944
- Fax
- (781) 890-5775
- NPI assigned
- Jul 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 19572 | MA | Primary |
Addresses
Primary practice location
840 Winter St
Attn: Pro Sports Therapy
Waltham, MA 02451-1433
Mailing address
840 Winter St
Attn: Pro Sports Therapy
Waltham, MA 02451-1433
Phone (781) 487-9944
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19572 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310688000000",
"number": "1912295650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 WINTER ST",
"address_2": "ATTN: PRO SPORTS THERAPY",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511433",
"telephone_number": "781-487-9944",
"fax_number": "781-890-5775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 WINTER ST",
"address_2": "ATTN: PRO SPORTS THERAPY",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511433",
"telephone_number": "781-487-9944",
"fax_number": "781-890-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JARED",
"middle_name": "S",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-15",
"last_updated": "2011-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "19572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.