Individual provider Active NPI

Nicholas Kovacev, DPT

  • Physical Therapist
  • Malden, MA
National Provider Identifier
1992259394
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22311 Issued in MA
Practice address
99 Dartmouth St
Malden, MA 02148-5103
Phone
(781) 605-1225
Fax
(781) 605-3451
NPI assigned
Aug 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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 22311 MA Primary

Addresses

Primary practice location

99 Dartmouth St
Malden, MA 02148-5103

Mailing address

1 Credit Union Way
FL3
Randolph, MA 02368-4633
Phone (781) 961-3370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921000849 MA Practitioner - Physical Therapist in Private Practice 2062709991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine North Orthopaedic Surgery, Inc.Group PAC ID 0547259095, 87 clinicians

Practice addresses (Care Compare)

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine North Orthopaedic Surgery, Inc. Physical Therapist CurrentSince Jun 24, 2019 Accepting new patients
Sports Medicine North Orthopaedic Surgery, Inc Physical Therapist CurrentSince Jun 24, 2019 Accepting new patients

Locations

1 Orthopedics Dr
Ste 2
Peabody, MA 01960
Phone (978) 818-6493

1 Orthopedics Dr
Peabody, MA 01960
Phone (781) 595-4562

Interoperability endpoints

  • Direct secure messaging: nicholas.kovacev.1@7605.direct.athenahealth.com

Organizations & group practices 3

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1992259394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREDIT UNION WAY",
            "address_2": "FL3",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684633",
            "telephone_number": "781-961-3370",
            "fax_number": "781-961-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 DARTMOUTH ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485103",
            "telephone_number": "781-605-1225",
            "fax_number": "781-605-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACEV",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.