Organization Active NPI

Physical and Functional Medicine Incorporated

  • Physical Medicine & Rehabilitation Physician
  • Portland, ME
National Provider Identifier
1134572316
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PHYSICAL AND FUNCTIONAL MEDICINE INCORPORATED
Practice address
335 Brighton Ave
Portland, ME 04102-2363
Phone
(347) 495-0357
NPI assigned
Jul 22, 2016
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Evan SavageNPI 1740546126
Title
President
Phone
(207) 784-2554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

335 Brighton Ave
Portland, ME 04102-2363

Mailing address

PO Box C
Freeport, ME 04032-0910
Phone (207) 775-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160930000508 ME Part B Supplier - Clinic/Group Practice 8224325519 Receives reassigned benefits from 2 practitioners
Practice locations: Portland, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1134572316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040320910",
            "telephone_number": "207-775-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022363",
            "telephone_number": "347-495-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL AND FUNCTIONAL MEDICINE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-784-2554"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.