SOUTHEASTERN PHYSICAL THERAPY – Physical Therapist, NPI 1982657433

SOUTHEASTERN PHYSICAL THERAPY is a healthcare provider. based in Boston, Massachusetts. specializing in Physical Therapist. The NPI Number for SOUTHEASTERN PHYSICAL THERAPY is 1982657433

Main info

Organization
Name
SOUTHEASTERN PHYSICAL THERAPY
NPI
1982657433
Phone
(914) 294-4050
Address
PO BOX 412307
Authorized Official
MICHAEL RUCKER CEO
Enumeration Date
18 May 2006
Last Update Date
9 September 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for SOUTHEASTERN PHYSICAL THERAPY

  • PO BOX 412307

    BOSTON, MA 022412307

    Phone: (914) 294-4050

    Type: Mailing

  • 1311 MAMARONECK AVE STE 140

    WHITE PLAINS, NY 106055224

    Phone: (914) 294-4050

    Type: Mailing

  • 5301, Providence Road, Haven Heights, Virginia Beach, Virginia, 23464, United States

    SUITE 80

    VIRGINIA BEACH, VA 234644128

    Phone: (757) 467-4604

    Fax: (757) 467-2716

    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: 2024-02-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

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
O20160826000390OIndependently-Practicing Physical TherapistVATBD
O20240202000799OPhysical/Occupational Therapy Group In Private PracticeVATBD
O20240212002520OClinic/Group PracticeDCTBD

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 02241)

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Reviews

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Frequently asked questions

Does SOUTHEASTERN PHYSICAL THERAPY share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SOUTHEASTERN PHYSICAL THERAPY uses 1982657433.
Can I rely on SOUTHEASTERN PHYSICAL THERAPY being an active provider?
As of the registry snapshot, SOUTHEASTERN PHYSICAL THERAPY is marked active.
What is SOUTHEASTERN PHYSICAL THERAPY best known for clinically?
Directory data describes SOUTHEASTERN PHYSICAL THERAPY with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is SOUTHEASTERN PHYSICAL THERAPY based?
SOUTHEASTERN PHYSICAL THERAPY is tied to Boston, Massachusetts in the data we show; additional addresses may exist on the full record.
Is the information about SOUTHEASTERN PHYSICAL THERAPY up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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