Individual provider Active NPI

Brett Alan Stuber, PT

  • Physical Therapist
  • Bangor, ME
National Provider Identifier
1255570909
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2407 Issued in ME
Practice address
1 Cumberland PL
Suite 108
Bangor, ME 04401-5083
Phone
(207) 990-9000
Fax
(207) 941-8645
NPI assigned
Feb 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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 PT2407 ME Primary

Addresses

Primary practice location

1 Cumberland PL
Suite 108
Bangor, ME 04401-5083

Mailing address

1 Cumberland PL
Suite 108
Bangor, ME 04401-5083
Phone (207) 990-9000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT2407MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gentiva Health Services 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.

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1255570909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND PL",
            "address_2": "SUITE 108",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015083",
            "telephone_number": "207-990-9000",
            "fax_number": "207-941-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CUMBERLAND PL",
            "address_2": "SUITE 108",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015083",
            "telephone_number": "207-990-9000",
            "fax_number": "207-941-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBER",
        "first_name": "BRETT",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.