VINEYARD COMPLEMENTARY MEDICINE, INC – Physical Therapy Clinic/Center, NPI 1053490896
Physical Therapy Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for VINEYARD COMPLEMENTARY MEDICINE, INC
426 State Rd
Vineyard Haven, MA 025685626
Phone: (508) 693-3800
Type: Location
9 Main St
Vineyard Haven, MA 025685400
Phone: (508) 693-3800
Type: Location
455 State Rd
Vineyard Haven, MA 025685695
Phone: (508) 693-3800
Type: Location
238, Edgartown-Vineyard Haven Road, Jerneganville, Edgartown, Dukes County, Massachusetts, 02539, United States
UNIT 1
EDGARTOWN, MA 025396932
Phone: (508) 693-3800
Fax: (508) 693-7473
Type: Location
Edgartown Post Office, Dark Woods Road, Edgartown, Dukes County, Massachusetts, 02539, United States
EDGARTOWN, MA 025391760
Phone: (508) 693-3800
Fax: (508) 693-7473
Type: Mailing
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: 2017-03-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (771 days ago).
Enrollment records
2
Earliest due date
2024-04-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20050608000387 | O | Physical/Occupational Therapy Group In Private Practice | MA | TBD |
| O20170310000520 | O | Clinic/Group Practice | MA | 2024-04-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 02568)
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