Nicole Rose Constantineau, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6418 Issued in ME

Practice address

94 Main St Unit 2
Gorham, ME 04038-1340

Phone

(207) 839-5860

NPI assigned

Jan 9, 2023

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

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Motion Physical Therapy LLCGroup PAC ID 7416926704, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Back in Motion Physical Therapy, LLC

  • Physical Therapist
  • Gorham, ME
  • NPI 1821165960
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1194439786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 MAIN ST UNIT 2",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381340",
            "telephone_number": "207-839-5860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1041 Brighton Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041021042",
            "country_code": "US",
            "telephone_number": "207-699-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSTANTINEAU",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Brooke Clark, PHARMD
• Kimberly L Clark, OT
• Andrew Coffin, BHP, DSP, CRMA
• Community Pharmacies LLC.
• Community Pharmacies, LLC.
• Mikaela Coombs
• Deborah Ann Cooper
• Karalyn Ethel Corbett, LCSW
• Core Elements LLC
• Michelle L Cote-Brzoza, OD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.