Organization Active NPI

Northern Physical Therapy & Rehab Services LLC

  • Physical Therapist
  • Presque Isle, ME
National Provider Identifier
1053471607
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHERN PHYSICAL THERAPY & REHAB SERVICES LLC
Practice address
34 North St
Suite 6
Presque Isle, ME 04769-2264
Phone
(207) 764-0400
Fax
(207) 764-0499
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Authorized official

Name
Mr. Samir Doshi
Title
Owner
Phone
(860) 285-0635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

34 North St
Suite 6
Presque Isle, ME 04769-2264

Mailing address

35 Hampden PL
Windsor, CT 06095-1477
Phone (860) 285-0635

Other identifiers 1

IdentifierTypeStateIssuer
DF5848OtherMERAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041119000443 ME Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5991769887 Receives reassigned benefits from 2 practitioners
Practice locations: Presque Isle, ME

National Provider Directory

National Provider Directory

Locations

52 Academy St
Presque Isle, ME 04769
Phone (207) 764-0400

34 North St
Ste 6
Presque Isle, ME 04769
Phone (207) 764-0400

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1053471607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HAMPDEN PL",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951477",
            "telephone_number": "860-285-0635",
            "fax_number": "860-271-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NORTH ST",
            "address_2": "SUITE 6",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692264",
            "telephone_number": "207-764-0400",
            "fax_number": "207-764-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PHYSICAL THERAPY & REHAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "DOSHI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-285-0635",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF5848",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.