Individual provider Active NPI

Alexandra Bernard, PT

  • Physical Therapist
  • South Portland, ME
National Provider Identifier
1558038125
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6025 Issued in ME
Practice address
185 Ocean St
South Portland, ME 04106-3600
Phone
(207) 799-8226
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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 PT6025 ME Primary

Addresses

Primary practice location

185 Ocean St
South Portland, ME 04106-3600

Mailing address

94 Main St
Gorham, ME 04038-1340
Phone (207) 839-5860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT6025MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Physical Therapy, LLC Physical Therapist CurrentSince Aug 29, 2021 Accepting new patients

Locations

94 Main St
Gorham, ME 04038
Phone (207) 839-5225

185 Ocean St
South Portland, ME 04106
Phone (207) 799-8226

Organizations & group practices 1

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1558038125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 MAIN ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381340",
            "telephone_number": "207-839-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OCEAN ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063600",
            "telephone_number": "207-799-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "ALEXANDRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT6025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.