Individual provider Active NPI

Cody St.Germain, DPT

  • Physical Therapist
  • Dixfield, ME
National Provider Identifier
1053894535
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5220 Issued in ME
Practice address
23 Newton Ave
Dixfield, ME 04224-9518
Phone
(207) 418-7075
NPI assigned
Sep 11, 2018
Last updated
Sep 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5220 ME Primary

Addresses

Primary practice location

23 Newton Ave
Dixfield, ME 04224-9518

Mailing address

23 Newton Ave
Dixfield, ME 04224-9518
Phone (207) 418-7075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181025000682 ME Practitioner - Physical Therapist in Private Practice 8123371960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smartcare IncGroup PAC ID 5395713028, 2 clinicians

Practice addresses (Care Compare)

94 Weld St
Dixfield, ME 04224-9207
Phone (207) 562-8048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5220MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Apr 1, 2021 Accepting new patients
Central Maine Medical Center CurrentSince Apr 1, 2021 Accepting new patients
Smartcare Inc Physical Therapist CurrentSince Sep 28, 2018 Accepting new patients
Lauren Hebert, PT,SC Physical Therapist PastSince Sep 28, 2018 Accepting new patients

Locations

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1053894535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 NEWTON AVE",
            "city": "DIXFIELD",
            "state": "ME",
            "postal_code": "042249518",
            "telephone_number": "207-418-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 NEWTON AVE",
            "city": "DIXFIELD",
            "state": "ME",
            "postal_code": "042249518",
            "telephone_number": "207-418-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.GERMAIN",
        "first_name": "CODY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixfield, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.