Individual provider Active NPI

Laura Ann Roach, P.T.

  • Physical Therapist
  • Auburn, ME
National Provider Identifier
1104143601
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3582 Issued in ME
Practice address
690 Minot Ave
Auburn, ME 04210-3922
Phone
(207) 783-3450
Fax
(207) 777-3979
NPI assigned
Apr 23, 2010
Last updated
Apr 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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 PT3582 ME Primary

Addresses

Primary practice location

690 Minot Ave
Auburn, ME 04210-3922

Mailing address

690 Minot Ave
Auburn, ME 04210-3922
Phone (207) 783-3450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724002372 ME Practitioner - Physical Therapist in Private Practice 1850648767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1399 Maine St
Poland, ME 04274-7303
Phone (207) 998-5493

400 N St
Suite 2
Saco, ME 04072-1867
Phone (207) 282-7121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Holdings Inc CurrentSince Jun 1, 2018 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist Current Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince May 1, 2019 Accepting new patients
Select Physical Therapy Holdings, Inc. Physical Therapist CurrentSince Jun 1, 2018 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince May 1, 2019 Accepting new patients

Locations

730 Center St
Ste 9
Auburn, ME 04210
Phone (207) 783-3450

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1104143601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-3450",
            "fax_number": "207-777-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-3450",
            "fax_number": "207-777-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.