Susanne Martornao

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT1187 Issued in ME

Practice address

14 Murray Drive
Gorham, ME 04038

Phone

(207) 233-7373

Fax

(888) 731-2721

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southern Maine Pediatric Therapies, PLLC

  • Occupational Therapist
  • Gorham, ME
  • NPI 1174867576
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1467595322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MURRAY DRIVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "04038",
            "telephone_number": "207-233-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MURRAY DRIVE",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "04038",
            "telephone_number": "207-233-7373",
            "fax_number": "888-731-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTORNAO",
        "first_name": "SUSANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT1187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MAINE",
            "identifier": "061223",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287920099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AENTA",
            "identifier": "1284152",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maine Residential Option, LLC
• Stacey M Marcoux, LMT,CA
• Regina P Marsters, LCPC, PHD
• Sergio Martin Acuna
• Alexander John Martin, PHARMD
• Margaret Masiak Beliveau, DPT
• Alan Joseph Mathieu, O.D.
• Breanna Lee Matthews
• Maureen Wood
• Melanie Grace Mauro, LCSW

• All providers in Gorham, ME
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.