Brandon Anderson

Individual provider Active NPI Physical Therapist · South Easton, MA

NPI 1992429971 · NPPES record last updated Oct 3, 2022

Key facts

NPI
1992429971
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
26377 (MA)
Practice address
566 Washington St
South Easton, MA 02375-1946
Phone
(508) 559-5108
NPI assigned
Oct 3, 2022
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliott Physical Therapy, Inc (60 clinicians)

Practice addresses (Care Compare)

566 Washington St
Suite 1
South Easton, MA 02375-1946
Phone (508) 559-5108

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221031001705 MA Practitioner - Physical Therapist in Private Practice 2961879234 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Elliott Physical Therapy, Inc. Physical Therapist Current
since Aug 12, 2022
Accepting new patients

Locations

960 William T Morrissey Blvd
Dorchester, MA 02122
Phone (617) 506-7210

566 Washington St
Ste 1
South Easton, MA 02375
Phone (508) 559-5108

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 26377 MA Yes

Addresses

Primary practice location

566 Washington St
South Easton, MA 02375-1946

Mailing address

566 Washington St
South Easton, MA 02375-1946
Phone (508) 559-5108

Other providers in South Easton, MA

All providers in South Easton, MA · Physical Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.