Michael McRae
Individual provider Active NPI Physical Therapy Assistant · Lewiston, ME
NPI 1487318549 · NPPES record last updated Oct 26, 2021
Key facts
- NPI
- 1487318549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PA6061 (ME)
- Practice address
- 102 Campus Ave
Lewiston, ME 04240-6019 - Phone
- (207) 777-4200
- NPI assigned
- Oct 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA6061 | ME | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PA6061 | ME | Yes |
Addresses
Primary practice location
102 Campus Ave
Lewiston, ME 04240-6019
Mailing address
75 Mayflower Hill Dr
Waterville, ME 04901-4718
Phone (215) 760-3283
NPI Registry JSON
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1487318549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 MAYFLOWER HILL DR",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049014718",
"telephone_number": "215-760-3283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 CAMPUS AVE",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042406019",
"telephone_number": "207-777-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCRAE",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ME",
"license": "PA6061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
- Carolyn Miles McNamara
- Helen McNelly
- Virginia Samel McNulty
- Scott H. McQuilkin
- Kemedy McQuillen
- Jean McWilliams
- Danielle Meader
- Medcare LLC
- Medical Care Management, Inc
- Medical Rehabilitation Associates
All providers in Lewiston, ME · Physical Therapy Assistant in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.