OrganizationActive
NPI 1104639731 · Physical Therapy Clinic/Center · Waltham, MA
Provider details
- NPI number
- 1104639731
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Yolanda Rodriguez, President(781) 916-8825
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Basic profile(47/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
80% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
40 Crescent St Ste 104
Waltham, MA 02453-4313
Phone: (781) 916-8825
Fax: (781) 701-3570
Street-level locationGet directions
Mailing address
40 Crescent St Ste 104
Waltham, MA 02453-4313
Registry dates
- Enumerated
- 2025-01-28
- Last updated
- 2025-02-09
- Certified
- 2025-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.