Alyssa Mary Goodwin, OTR
Individual provider Active NPI Occupational Therapist · Braintree, MA
NPI 1992554083 · NPPES record last updated May 13, 2024
Key facts
- NPI
- 1992554083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 12728 (MA)
- Practice address
- 175 Grove St
Braintree, MA 02184-7253 - Phone
- (781) 848-2050
- NPI assigned
- May 13, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthpro Heritage Rehab and Fitness LLC
Practice addresses (Care Compare)
86 Saunders Rd
Norwood, MA 02062-3242
Phone (781) 285-7950
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240528003107 | MA | Practitioner - Occupational Therapist in Private Practice | 3274975842 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current |
Accepting new patients |
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current |
Accepting new patients |
Locations
86 Saunders Rd
Norwood, MA 02062
Phone (781) 285-7950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12728 | MA | Yes |
Addresses
Primary practice location
175 Grove St
Braintree, MA 02184-7253
Mailing address
91 Mechanic St
Canton, MA 02021-3110
Phone (508) 212-5367
Other names
- Alyssa Mary King
NPI Registry JSON
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1992554083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 MECHANIC ST",
"city": "CANTON",
"state": "MA",
"postal_code": "020213110",
"telephone_number": "508-212-5367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 GROVE ST",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021847253",
"telephone_number": "781-848-2050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "ALYSSA",
"middle_name": "MARY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "12728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALYSSA",
"last_name": "KING",
"middle_name": "MARY",
"credential": "OTR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Braintree, MA
- Elizabeth Good
- Hilary Gooding
- Miriam Elana Iken Goodman
- Vanessa Rita Goodman
- Rosemary Goodrow
- Rachel Gostkowski
- Hannah Graham
- Eric Grant
- Krista Gray
- Great Hill Dental Partners, LLC
All providers in Braintree, MA · Occupational Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.