Polyxenia J Pantos, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4102 Issued in ME

Practice address

32 Hall St
South Portland, ME 04106-3315

Phone

(617) 435-0744

NPI assigned

Nov 16, 2021

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Select Physical Therapy Holdings, Inc.

  • Rehabilitation Clinic/Center
  • Farmington, ME
  • NPI 1427564590
  Medicare reassignment NPD
• Piping Plover Therapies

  • Pediatric Occupational Therapist
  • South Portland, ME
  • NPI 1962240895

  Pediatrics

  NPD Authorized official
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1619633401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HALL ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063315",
            "telephone_number": "617-435-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 HALL ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063315",
            "telephone_number": "617-435-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOS",
        "first_name": "POLYXENIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2021-11-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13707",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ME",
            "license": "OT4102",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise C. Ouellette, LCPC-C
• Adam Wesley Owen, MD
• Melissa Marie Page, MS, RD, CSOWM, LDN
• James Hyunseok Pak, ATC
• David Palmer, DMD
• Katherine Paret, DMD
• Margaret Chadbourne Parizo, LCSW
• Amy F. Parker, MD
• Andrew Parker, LCSW
• James P Parker, M.D.

• Occupational Therapist in South Portland, ME
• Providers in South Portland, ME by specialty
• Occupational Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.