SOUTH SHORE SPORTS & MUSCULAR – Orthopedic Physical Therapist, NPI 1104822576

SOUTH SHORE SPORTS & MUSCULAR is a healthcare provider. based in East weymouth, Massachusetts. specializing in Orthopedic Physical Therapist. The organization holds a License No. 5290 (MA). The NPI Number for SOUTH SHORE SPORTS & MUSCULAR is 1104822576

Main info

Organization
Name
SOUTH SHORE SPORTS & MUSCULAR
NPI
1104822576
Phone
(781) 331-9600
Address
90 LIBBEY INDUSTRIAL PKWY
Authorized Official
MR. STEPHEN LALLY NEWCOMB GENERAL MANAGER
Enumeration Date
22 June 2005
Last Update Date
19 December 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for SOUTH SHORE SPORTS & MUSCULAR

  • South Shore Medical Center, 90, Libbey Industrial Parkway, Weymouth, Norfolk County, Massachusetts, 02188, United States

    STE 103

    EAST WEYMOUTH, MA 021893129

    Phone: (781) 331-9600

    Fax: (781) 335-1556

    Mailing address matches the actual address.

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: 2004-03-23

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
O20040323000056OClinic/Group 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 02189)

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Reviews

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Frequently asked questions

Can I verify SOUTH SHORE SPORTS & MUSCULAR with an NPI only?
You can start verification with NPI 1104822576 for SOUTH SHORE SPORTS & MUSCULAR, then check state licensing separately.
Is SOUTH SHORE SPORTS & MUSCULAR still practicing?
SOUTH SHORE SPORTS & MUSCULAR is currently listed as active in the public NPI registry.
What is SOUTH SHORE SPORTS & MUSCULAR's specialty?
The listing groups SOUTH SHORE SPORTS & MUSCULAR with Orthopedic Physical Therapist. Clinical services aligned with this taxonomy classification.
Does SOUTH SHORE SPORTS & MUSCULAR list a practice location?
Patients near East Weymouth, Massachusetts may find SOUTH SHORE SPORTS & MUSCULAR in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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