Russell Carroll Allen Jr., PT, DPT
Individual provider Active NPI Physical Therapist · Auburn, ME
NPI 1124851803 · NPPES record last updated Aug 25, 2024
Key facts
- NPI
- 1124851803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT6934 (ME)
- Practice address
- 690 Minot Ave Ste 2
Auburn, ME 04210-3922 - Phone
- (207) 753-3456
- Fax
- (207) 782-9000
- NPI assigned
- Aug 20, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Greater Brunswick Physical Therapy PA
Practice addresses (Care Compare)
11 Bowdoin Mill Is
Suite 260
Topsham, ME 04086-1274
Phone (207) 729-1164
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240917001523 | ME | Practitioner - Physical Therapist in Private Practice | 2567903685 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Maine Medical Center | Current |
Accepting new patients | |
| Central Maine Medical Center | Current | Accepting new patients | |
| Central Maine Medical Center | Current |
Accepting new patients | |
| Greater Brunswick Physical Therapy P.a. | Physical Therapist | Current |
Accepting new patients |
Locations
690 Minot Ave
#2
Auburn, ME 04210
Phone (207) 753-3456
300 Main St
Lewiston, ME 04240
Phone (207) 795-2400
11 Bowdoin Mill Is
Ste 260
Topsham, ME 04086
Phone (207) 729-1164
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6934 | ME | Yes |
Addresses
Primary practice location
690 Minot Ave Ste 2
Auburn, ME 04210-3922
Mailing address
174 Fletcher Rd
Auburn, ME 04210-8874
Phone (207) 577-4142
Other providers in Auburn, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.