Individual provider Active NPI

Emma G Roberts, PT

  • Physical Therapist
  • Cape Elizabeth, ME
National Provider Identifier
1346852316
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5763 Issued in ME
Practice address
2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107
Phone
(207) 767-9773
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040.0134187 VT
Physical Therapist 225100000X PT5763 ME Primary

Addresses

Primary practice location

2 Davis Point LN Unit 1a
Cape Elizabeth, ME 04107

Mailing address

426 Industrial Ave Ste 190
Williston, VT 05495-7904
Phone (802) 489-6244

Other practice location 1

127 Long Sands Rd
York, ME 03909-1158
Phone (207) 361-3888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210311002177 ME Practitioner - Physical Therapist in Private Practice 9133535453 Reassigns benefits to 1 organization
I20230504002209 VT Practitioner - Physical Therapist in Private Practice 9133535453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT 360 IncGroup PAC ID 0749469906, 18 clinicians

Practice addresses (Care Compare)

426 Industrial Ave
Suite 190
Williston, VT 05495-7904
Phone (802) 860-4360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5763MEMDPhysical Therapist
040.0134187VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Rehab, LLC Physical Therapist CurrentSince Mar 5, 2021 Accepting new patients
PT 360 Inc Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Greater Brunswick Physical Therapy P.a. Physical Therapist CurrentSince Jul 12, 2021 Accepting new patients

Locations

2 Davis Point Ln
Unit 1A
Cape Elizabeth, ME 04107
Phone (207) 767-9773

583 Lisbon St
Ste 3
Lisbon Falls, ME 04252

11 Bowdoin Mill Is
Ste 260
Topsham, ME 04086
Phone (207) 729-1164

120 Graham Way
Ste 110
Shelburne, VT 05482
Phone (802) 657-7990

426 Industrial Ave
Ste 190
Williston, VT 05495
Phone (802) 657-7990

Organizations & group practices 3

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": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1346852316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 INDUSTRIAL AVE STE 190",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957904",
            "telephone_number": "802-489-6244",
            "fax_number": "802-488-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DAVIS POINT LN UNIT 1A",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "04107",
            "telephone_number": "207-767-9773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Long Sands Rd",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "ME",
            "postal_code": "039091158",
            "country_code": "US",
            "telephone_number": "207-361-3888",
            "fax_number": "207-361-3899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "EMMA",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0134187",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Elizabeth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.