Individual provider Active NPI

Stephanie Maguire, PT, DPT

  • Physical Therapist
  • Bangor, ME
National Provider Identifier
1407236755
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3675 Issued in ME
Practice address
31 Bangor Mall Blvd
Bangor, ME 04401-3612
Phone
(207) 291-5714
Fax
(207) 433-1246
NPI assigned
Jun 2, 2015
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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 PT3675 ME Primary

Addresses

Primary practice location

31 Bangor Mall Blvd
Bangor, ME 04401-3612

Mailing address

31 Bangor Mall Blvd
Bangor, ME 04401-3612
Phone (207) 291-5714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111000842 ME Practitioner - Physical Therapist in Private Practice 3274067434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beane Family Ventures Inc. CurrentSince Sep 9, 2024 Accepting new patients
Beane Family Ventures Inc. Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
L Thomas Cashio MD & Mark Juneau Jr MD,PC Past Accepting new patients

Locations

31 Bangor Mall Blvd
Bangor, ME 04401
Phone (207) 291-5714

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

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1407236755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BANGOR MALL BLVD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013612",
            "telephone_number": "207-291-5714",
            "fax_number": "207-433-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 BANGOR MALL BLVD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013612",
            "telephone_number": "207-291-5714",
            "fax_number": "207-433-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGUIRE",
        "first_name": "STEPHANIE",
        "name_prefix": "Miss",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3675",
            "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 Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.