Tracy Pomerleau, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OA3904 Issued in ME

Practice address

207 E Main St
Dover Foxcroft, ME 04426-1246

Phone

(207) 343-1084

NPI assigned

Jul 12, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1225762602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261246",
            "telephone_number": "207-343-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERLEAU",
        "first_name": "TRACY",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OA3904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OA3904",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Wayne Pike, FNP-C
• Lisa Pinkham, PHARMD
• Krisann Pino
• Sarah A Plewinski, PA
• Natali Elaine Plourde, LMSW-CC
• Makaelyn Makenzie Porter, DPT
• Laura Marie Provancha, RDH
• Prymca
• Shawn Pushor, RPH
• Ready Set Grow

• Occupational Therapy Assistant in Dover Foxcroft, ME
• Providers in Dover Foxcroft, ME by specialty
• Occupational Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.