INNOVATIVE PHYSICIAN SERVICES LLC – Physical Medicine & Rehabilitation Physician, NPI 1922096049
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for INNOVATIVE PHYSICIAN SERVICES LLC
95;103;119, Frank B Murray Street, Metro Center, Springfield, Hampden County, Massachusetts, 01103, United States
SPRINGFIELD, MA 011031106
Phone: (413) 301-6019
Type: Location
512 W Cherry St Ste C
Kissimmee, FL 347414114
Phone: (321) 400-5013
Fax: (413) 363-9123
Type: Location
490 PAGE BOULEVARD
SPRINGFIELD, MA 01104
Phone: (413) 349-5063
Fax: (413) 363-2857
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: 2022-12-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
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 |
|---|---|---|---|---|
| O20040427000199 | O | Clinic/Group Practice | MA | TBD |
| O20221206001271 | O | Clinic/Group Practice | FL | TBD |
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.
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 01103)
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