Physical Rehabilitation of Southern Maine PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

014605 Issued in ME

Legal business name

PHYSICAL REHABILITATION OF SOUTHERN MAINE PC

Doing business as

Mary Macy MD

Practice address

335 Brighton Ave
Portland, ME 04102-2362

Phone

(207) 497-2996

Fax

(207) 497-3467

NPI assigned

Apr 5, 2007

Organization subpart

No

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

Authorized official

Name

Mary A Macy, M.D.NPI 1811907199

Title

Owner

Phone

(207) 854-1544

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mary Macy MD Doing business as

Practitioners 1

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

• Mary A Macy, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Bangor, ME
  • NPI 1811907199
  NPD (past) Authorized official

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1144342585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040980810",
            "telephone_number": "207-854-1544",
            "fax_number": "207-854-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022362",
            "telephone_number": "207-497-2996",
            "fax_number": "207-497-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL REHABILITATION OF SOUTHERN MAINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-854-1544",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ME",
            "license": "014605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IND #",
            "identifier": "ME1098",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1811907199",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY #",
            "identifier": "$$$$$$$$$",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "061235",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Macy MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel S Phillips, MS, OTR
• Stephanie G Phillips, M.A., J.D., LMFT
• Adi Michelle Philpott, DO
• Mojabeng Phoofolo, M.D.
• Physical and Functional Medicine Incorporated
• Bernadeth Lyn Cal Piamonte, MD
• Gretchen A. Pianka, M.D.
• Michelle Anne Picard, CRNA
• Alan Picarillo
• Bethany J Picker, MD

• Physical Medicine & Rehabilitation Physician in Portland, ME
• Providers in Portland, ME by specialty
• Physical Medicine & Rehabilitation Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.