Individual provider Active NPI

Tessa Goldstein, DPT

  • Physical Therapist
  • South Portland, ME
National Provider Identifier
1194555102
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6906 Issued in ME
Practice address
185 Ocean St
South Portland, ME 04106-3600
Phone
(207) 799-8226
NPI assigned
Aug 5, 2024
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6906 ME Primary

Addresses

Primary practice location

185 Ocean St
South Portland, ME 04106-3600

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240813004076 ME Practitioner - Physical Therapist in Private Practice 9234677998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Move Forward PT LLCGroup PAC ID 6002233426, 2 clinicians

Practice addresses (Care Compare)

South Portland, ME 04106
Phone (207) 712-6869

85 E St
South Portland, ME 04106-2870
Phone (207) 835-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Move Forward PT, LLC Physical Therapist CurrentSince Aug 11, 2025 Accepting new patients
Back in Motion Physical Therapy, LLC Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients

Locations

94 Main St
Gorham, ME 04038
Phone (207) 839-5225

1041 Brighton Ave
Portland, ME 04102
Phone (207) 699-4111

2445 Congress St
Portland, ME 04102
Phone (207) 504-1524

185 Ocean St
South Portland, ME 04106
Phone (207) 799-8226

747 Broadway
South Portland, ME 04106
Phone (207) 712-6869

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1194555102",
    "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": "185 OCEAN ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063600",
            "telephone_number": "207-799-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "TESSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.