Individual provider Active NPI

Marie-Josee McKenzie, PT

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1952472763
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15870 Issued in MA
Practice address
495 Columbus Ave
Boston, MA 02118-3250
Phone
(617) 262-7555
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 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 15870 MA Primary

Addresses

Primary practice location

495 Columbus Ave
Boston, MA 02118-3250

Mailing address

1 Franklin St Unit 4505
Boston, MA 02110-1299
Phone (617) 899-6075

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5304

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

LicenseStateTypeSpecialty
15870MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1952472763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FRANKLIN ST UNIT 4505",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101299",
            "telephone_number": "617-899-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 COLUMBUS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183250",
            "telephone_number": "617-262-7555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "MARIE-JOSEE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "15870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.