Anne-Marie Ruth Provencal, MS OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4896 Issued in ME

Practice address

400 North St Ste 2
Saco, ME 04072-1867

Phone

(207) 282-7121

NPI assigned

Sep 5, 2019

Last updated

Oct 6, 2025By the provider in NPPES

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

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, 137 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saco Bay Orthopaedic and Sports Physical Therapy, Inc

  dba Saco Bay Orthopaedic Sports & Physical Therapy

  • Physical Therapist
  • Saco, ME
  • NPI 1346254315

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.

  dba Saco Bay Orthopaedic Sports & Physical Therapy

  • Physical Therapy Clinic/Center
  • Westbrook, ME
  • NPI 1396312807
  NPD

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1265081905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 BRUNELLE AVE",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040735532",
            "telephone_number": "207-299-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH ST STE 2",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721867",
            "telephone_number": "207-282-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCAL",
        "first_name": "ANNE-MARIE",
        "middle_name": "RUTH",
        "credential": "MS OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Porter, LCSW
• Alan Potyk, M.D.
• Barbara Potyk, M.D.
• Maura Beverlin Price, MD
• Laura B Prime, LMSW-CC
• Qaisi Homecare Inc
• Barbara Rachel, LCSW
• Rebecca Rafferty, OTR/L
• Deanna Rose Rainey
• Patricia Rand

• Occupational Therapist in Saco, ME
• Providers in Saco, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.