Active NPI
Leonard Macrina, PT
- Sports Physical Therapist
- Waltham, MA
National Provider Identifier
1962432690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 17706
- Practice address
- 110 Clematis Ave
Suite 2
Waltham, MA 02453-7013 - Phone
- (617) 992-2984
- NPI assigned
- Jul 5, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH4256 | AL | |
| Sports Physical Therapist | 2251S0007X | 17706 | MA | Primary |
Addresses
Primary practice location
110 Clematis Ave
Suite 2
Waltham, MA 02453-7013
Mailing address
110 Clematis Ave
Suite 2
Waltham, MA 02453-7013
Phone (617) 992-2984
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7878489 | Other | AL | AETNA |
| 51530163 | Other | AL | BCBS OF AL |
| 890016400 | Medicaid | AL |
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 |
|---|---|---|---|
| PTH4256 | AL | MD | Physical Therapist |
| 17706 | MA | MD | Sports Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Associates, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490486400000",
"number": "1962432690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CLEMATIS AVE",
"address_2": "SUITE 2",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024537013",
"telephone_number": "617-992-2984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CLEMATIS AVE",
"address_2": "SUITE 2",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024537013",
"telephone_number": "617-992-2984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACRINA",
"first_name": "LEONARD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2017-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH4256",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "MA",
"license": "17706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7878489",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF AL",
"identifier": "51530163",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890016400",
"state": "AL"
}
],
"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 Mar 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.