Individual provider Active NPI

Andrew Ciarletta, PT

  • Physical Therapist
  • Wayland, MA
National Provider Identifier
1962554774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11191 Issued in MA
Practice address
524 Boston Post Rd
Wayland, MA 01778-1833
Phone
(508) 358-4900
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 11191 MA Primary

Addresses

Primary practice location

524 Boston Post Rd
Wayland, MA 01778-1833

Mailing address

111 Water St
Apt. #7
Beverly, MA 01915-5060

Other identifiers 1

IdentifierTypeStateIssuer
Y67613OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000691 MA Practitioner - Physical Therapist in Private Practice 8921038423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Doaks LN
Marblehead, MA 01945-3584
Phone (781) 797-0844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11191MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Step Ahead Physical Therapy Physical Therapist CurrentSince Mar 9, 2011 Accepting new patients
Fusion - Osmed Mso, LLC PastSince Sep 29, 2024 Accepting new patients
Orthosports & Aquatic Physical Therapy, PC Physical Therapist PastSince Feb 26, 1999 Accepting new patients
Tim Dreher PT & Associates, Inc. Physical Therapist PastSince Jan 5, 2025 Accepting new patients

Locations

14 Bessom St
Marblehead, MA 01945
Phone (617) 697-7371

50 Doaks Ln
Marblehead, MA 01945
Phone (617) 776-2227

Organizations & group practices 4

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962554774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WATER ST",
            "address_2": "APT. #7",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 BOSTON POST RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017781833",
            "telephone_number": "508-358-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARLETTA",
        "first_name": "ANDREW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y67613",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayland, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.