Samantha Gagne

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6058 Issued in ME

Practice address

77 Bates St Ste 201
Lewiston, ME 04240-7637

Phone

(207) 795-2122

NPI assigned

Sep 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of New England, College of Osteo Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgewater Orthopedic Physical Therapy, LLCGroup PAC ID 2961599907, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

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

• Edgewater Orthopedic Physical Therapy, LLC

  • Physical Therapist
  • Falmouth, ME
  • NPI 1053518332
  Medicare reassignment Care Compare group NPD
• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment NPD
• Central Maine Medical Center

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1154090348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BATES ST STE 201",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407637",
            "telephone_number": "207-795-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BATES ST STE 201",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407637",
            "telephone_number": "207-795-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Functional Spine Center, PA
• Katlyn Marie Furness, LADC,CCS
• Amy Lynn Gabrielski, CADC
• Alyssa Ann Gagne
• Amanda Gagne, OTR/L
• Tracy Gagne, SLP
• Allison Maria Gagnon, PA-C
• Amanda J Gagnon, DO
• Cassandra Ann Gagnon, LD
• Marc Gagnon, OT

• Physical Therapist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.