Michaela A Reynolds, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1150 Issued in ME

Practice address

5 Millbrook Rd
Scarborough, ME 04074-9702

Phone

(207) 510-6500

Fax

(207) 510-6565

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Performance Physical Therapy,LLCGroup PAC ID 5799701819, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optimal Performance Physical Therapy,LLC

  • Physical Therapist
  • Scarborough, ME
  • NPI 1518953959
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1053406140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COULTHARD FARMS RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747506",
            "telephone_number": "207-510-6500",
            "fax_number": "207-510-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MILLBROOK RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749702",
            "telephone_number": "207-510-6500",
            "fax_number": "207-510-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAELA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT1150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11507673",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "061508",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1173427",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael W Rementer, DC
• Scot C Remick, MD
• Resilience Maine, LLC
• Results Speech and Language Therapy, PLLC
• Dorothea Rex, M.S., P.T.
• Thomas Q Reynolds, DO
• Samantha Ricci, MD
• Megan Ann Richard, AGACNP-BC
• Katharine Kennesaw Richards, NP
• Jessica Adelaide Richardson, NP

• Physical Therapist in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.