Provider Demographics
NPI:1679582175
Name:PINNACLE REHABILITATION NETWORK, LLC
Entity Type:Organization
Organization Name:PINNACLE REHABILITATION NETWORK, LLC
Other - Org Name:BLUE HILLS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTA NATARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-388-7272
Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:340 WOOD RD STE 303
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2404
Practice Address - Country:US
Practice Address - Phone:781-535-6053
Practice Address - Fax:781-535-6056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINNACLE REHABILITATION NETWORK, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-05
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110074251AMedicaid
MAY61486OtherBCBS MASS GROUP #
MA0003839807OtherAETNA MA GROUP #
MA9745840Medicaid
487882908OtherDEPT LABOR FACILITY #
630364OtherTUFTS HEALTH PLAN GROUP #
7819287OtherCIGNA GROUP #
5717325OtherCCN FACILITY #
AA 11345OtherHARVARD PILGRIM GROUP #