Active NPI
Ivy C Mussomeli, DPT
- Physical Therapist
- Auburn, ME
National Provider Identifier
1235451683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3637
- Practice address
- 690 Minot Ave
Auburn, ME 04210-3922 - Phone
- (207) 783-3450
- Fax
- (207) 777-3979
- NPI assigned
- Feb 25, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3637 | ME | Primary |
Addresses
Primary practice location
690 Minot Ave
Auburn, ME 04210-3922
Mailing address
690 Minot Ave
Auburn, ME 04210-3922
Phone (207) 783-3450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3637 | ME | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maine Feldenkrais & Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Brunswick, ME
- NPI 1477578268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1235451683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 MINOT AVE",
"city": "AUBURN",
"state": "ME",
"postal_code": "042103922",
"telephone_number": "207-783-3450",
"fax_number": "207-777-3979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 MINOT AVE",
"city": "AUBURN",
"state": "ME",
"postal_code": "042103922",
"telephone_number": "207-783-3450",
"fax_number": "207-777-3979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSSOMELI",
"first_name": "IVY",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-25",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "3637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.