Individual provider Active NPI

William F Scanlon, P.T.

  • Physical Therapist
  • Jamaica Plain, MA
National Provider Identifier
1982724449
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
MA7536 Issued in MA
Practice address
722 Centre St
Jamaica Plain, MA 02130-2516
Phone
(617) 522-5550
Fax
(617) 983-0884
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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 MA7536 MA Primary

Addresses

Primary practice location

722 Centre St
Jamaica Plain, MA 02130-2516

Mailing address

722 Centre St
Jamaica Plain, MA 02130-2516
Phone (617) 522-5550

Other identifiers 4

IdentifierTypeStateIssuer
37662OtherMAHARVARD PILGRIM
0006180OtherMANEIGHBORHOOD HEALTH PLAN
Y67013OtherMABLUE CROSS
0301825MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080625000675 MA Practitioner - Physical Therapist in Private Practice 3678644259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

722 Centre St
Jamaica Plain, MA 02130-2516
Phone (617) 522-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7536MAMDPsychologist
MA7536MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scanlon Physical Therapy Inc. Physical Therapist CurrentSince Jan 11, 1992 Accepting new patients

Locations

722 Centre St
Jamaica Plain, MA 02130
Phone (617) 522-5550

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1982724449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302516",
            "telephone_number": "617-522-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302516",
            "telephone_number": "617-522-5550",
            "fax_number": "617-983-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "WILLIAM",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "MA7536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "37662",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0006180",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y67013",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0301825",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.