NPIMap

Organization Active NPI

Preferred Therapy Outpatient Services of Me, LLC

  • Physical Therapist
  • Brunswick, ME
National Provider Identifier
1043973589
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PREFERRED THERAPY OUTPATIENT SERVICES OF ME, LLC
Practice address
142 Neptune Dr
Brunswick, ME 04011-2882
Phone
(860) 610-0400
NPI assigned
Oct 21, 2021
Last updated
Oct 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Rachael Percoco, PTNPI 1073687810
Title
Director of Outpatient Services
Phone
(860) 918-4742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

142 Neptune Dr
Brunswick, ME 04011-2882

Mailing address

850 Silas Deane Hwy FL 2
Wethersfield, CT 06109-3440
Phone (860) 610-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211118000564 ME Part B Supplier - Clinic/Group Practice 0345639001 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
Practice locations: Camden, ME
O20230511003244 ME Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 0345639001 Practice locations: Brunswick, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043973589. Details of each certification follow.

  • CCN 206535 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 206535

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PREFERRED THERAPY OUTPATIENT SERVICES OF ME, LLC
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Nov 29, 2023
Last certification
Nov 29, 2023
Ownership / control type
Proprietary
Facility address
142 Neptune Drive
Brunswick, ME 04011

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Preferred Therapy Outpatient Services of Me LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

30 Community Dr
Camden, ME 04843
Phone (207) 230-6100

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ledgewood Manor IncWindham, ME, CCN 205137 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 3, 2018
Jul 14, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1043973589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SILAS DEANE HWY FL 2",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093440",
            "telephone_number": "860-610-0400",
            "fax_number": "860-610-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 NEPTUNE DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112882",
            "telephone_number": "860-610-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED THERAPY OUTPATIENT SERVICES OF ME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "PERCOCO",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF OUTPATIENT SERVICES",
        "authorized_official_telephone_number": "860-918-4742",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.