Individual provider Active NPI

Emily Farrell

  • Physical Therapist
  • Beverly, MA
National Provider Identifier
1992354070
Registry record updated Dec 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24533 Issued in MA
Practice address
900 Cummings Ctr Ste 130S
Beverly, MA 01915-6183
Phone
(978) 524-7827
Fax
(978) 524-7828
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 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 24533 MA Primary

Addresses

Primary practice location

900 Cummings Ctr Ste 130S
Beverly, MA 01915-6183

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Other practice location 1

100 Washington St Ste B
Canton, MA 02021-4017
Phone (781) 214-6505

Other identifiers 1

IdentifierTypeStateIssuer
24533OtherMAPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190927003026 MA Practitioner - Physical Therapist in Private Practice 7416287735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proex Physical Therapy LLCGroup PAC ID 0345212395, 166 clinicians

Practice addresses (Care Compare)

300 Tradecenter
Suite 1650
Woburn, MA 01801-1884
Phone (781) 935-2655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24533MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proex Physical Therapy, LLC CurrentSince Mar 24, 2020 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Sep 3, 2019 Accepting new patients
Proex Physical Therapy, LLC Physical Therapist CurrentSince Mar 24, 2020 Accepting new patients
Marathon Physical Therapy and Sports Medicine, LLC Physical Therapist PastSince Sep 1, 2019 Accepting new patients

Locations

900 Cummings Ctr
Ste 130S
Beverly, MA 01915
Phone (978) 420-4878

10 High St
Ste 303
Boston, MA 02110
Phone (617) 542-6999

100 Washington St
Ste B
Canton, MA 02021
Phone (781) 214-6505

250 E Main St
Norton, MA 02766
Phone (508) 285-5533

99 Vanderbilt Ave
Norwood, MA 02062
Phone (781) 352-5400

22 Aarons Way
Unit 4
West Yarmouth, MA 02673
Phone (774) 352-7060

300 Tradecenter
Ste 1650
Woburn, MA 01801
Phone (781) 925-7643

576 Broadhollow Rd
Melville, NY 11747

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": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577145600000",
    "number": "1992354070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859",
            "fax_number": "631-396-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR STE 130S",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156183",
            "telephone_number": "978-524-7827",
            "fax_number": "978-524-7828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Washington St Ste B",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020214017",
            "country_code": "US",
            "telephone_number": "781-214-6505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "24533",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; 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.