Individual provider Active NPI

Thomas J Dubuque Jr., PT MSPT

  • Physical Therapist
  • East Providence, RI
National Provider Identifier
1952313728
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01833 Issued in RI
Practice address
1 Kettle Point Ave
East Providence, RI 02914-5375
Phone
(401) 330-1428
Fax
(401) 330-1447
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT01833 RI Primary

Addresses

Primary practice location

1 Kettle Point Ave
East Providence, RI 02914-5375

Mailing address

2 Dudley St
Suite 200
Providence, RI 02905-3236
Phone (401) 330-1428

Other identifiers 3

IdentifierTypeStateIssuer
640014EOtherUNITED HEALTH NEW ENGLAND
75277OtherRIRI BLUE CROSS
411376OtherRIRI BLUE CHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040419001439 RI Practitioner - Physical Therapist in Private Practice 8729073689 Reassigns benefits to 1 organization
I20240228001370 MA Practitioner - Physical Therapist in Private Practice 8729073689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians
Orthopedic Care Physician Network, LLCGroup PAC ID 7214185511, 36 clinicians

Practice addresses (Care Compare)

10 Reservoir St
Suite 101
Mansfield, MA 02048-3104
Phone (508) 618-7111

15 Roche Bros Way
North Easton, MA 02356-1000
Phone (781) 344-3535

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Care Physician Network, LLC CurrentSince Feb 15, 2024 Accepting new patients
University Orthopedics, Inc. CurrentSince Feb 15, 2024 Accepting new patients
Orthopedic Care Physician Network LLC CurrentSince Feb 15, 2024 Accepting new patients
Northern Ri Physical Therapy Physical Therapist PastSince Aug 1, 2015 Accepting new patients
Bay State Physical Therapy PC Physical Therapist PastSince Oct 1, 2023 Accepting new patients

Locations

10 Reservoir St
Ste 101
Mansfield, MA 02048
Phone (508) 618-7111

15 Roche Brothers Way
North Easton, MA 02356
Phone (781) 545-9273

675 Paramount Dr
Raynham, MA 02767
Phone (508) 828-5848

Networks

  • goperspecta network organization-21861

Interoperability endpoints

  • Direct secure messaging: thomas.dubuque.1@13709.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGDFCA

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1952313728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 200",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-330-1428",
            "fax_number": "401-330-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KETTLE POINT AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145375",
            "telephone_number": "401-330-1428",
            "fax_number": "401-330-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUQUE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "PT MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH NEW ENGLAND",
            "identifier": "640014E",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS",
            "identifier": "75277",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CHIP",
            "identifier": "411376",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.