KELLY MARIE WILLIAMSON (PT) – Physical Therapist, NPI 1962912550

KELLY MARIE WILLIAMSON (PT) is a healthcare provider. based in Cambridge, Massachusetts. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 23257 (MA). The NPI Number for KELLY MARIE WILLIAMSON (PT) is 1962912550

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
KELLY MARIE WILLIAMSON (PT)
NPI
1962912550
Phone
(617) 491-0264
Address
1 KENDALL SQ STE B14104
Enumeration Date
9 October 2017
Last Update Date
1 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5085441540
Graduation Year
2017 (9 years ago)
PAC ID
5991071110
Group Practice PAC ID
5799686549
Professional Enrollment ID
I20171016002161
Address ID
MA017482365HO1XXXXSTXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA

Provider Addresses for KELLY MARIE WILLIAMSON (PT)

  • 1 KENDALL SQ STE B14104

    CAMBRIDGE, MA 021391573

    Phone: (617) 491-0264

    Fax: (617) 494-4111

    Type: Location

  • 790, Remington Boulevard, Bolingbrook, Will County, Illinois, 60440, United States

    BOLINGBROOK, IL 604404909

    Phone: (630) 296-2222

    Fax: (630) 759-9510

    Type: Mailing

  • 54 MAIN ST STE 10

    LAKEVILLE, MA 023473622

    Phone: (508) 544-1540

    Fax: (508) 544-1541

    Type: Mailing

  • 1 LUMBER ST

    HOPKINTON, MA 017482363

    Phone: (508) 544-1540

    Fax: (508) 544-1541

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-10-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171016002161IPhysical Therapist In Private PracticeMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02139)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799686549View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeMA
-MA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeRI

Reviews

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Frequently asked questions

What is KELLY MARIE WILLIAMSON (PT)'s NPI number?
KELLY MARIE WILLIAMSON (PT)'s NPI is 1962912550 — the number used across U.S. healthcare to identify this provider.
Would KELLY MARIE WILLIAMSON (PT) appear as active to a payer?
You can treat KELLY MARIE WILLIAMSON (PT) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to KELLY MARIE WILLIAMSON (PT)?
KELLY MARIE WILLIAMSON (PT)'s specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KELLY MARIE WILLIAMSON (PT)?
Travel planning: use Cambridge, Massachusetts as the reference point for KELLY MARIE WILLIAMSON (PT), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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