Kristen Lee Amidon, PT, DPT
Individual provider Active NPI Physical Therapist · Standish, ME
NPI 1629796958 · NPPES record last updated Aug 22, 2022
Key facts
- NPI
- 1629796958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT6328 (ME)
- Practice address
- 111 Ossipee TRL E Ste 1151
Standish, ME 04084-6421 - Phone
- (207) 642-5325
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Magnolia Outpatient Physical Therapy Services, LLC
Practice addresses (Care Compare)
24 Martin LN
Belfast, ME 04915-6099
Phone (207) 447-0780
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220929003168 | ME | Practitioner - Physical Therapist in Private Practice | 4284010190 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT6328 | ME | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saco Bay Orthopaedic and Sports Physical Therapy, Inc. | Current |
Accepting new patients | |
| Magnolia Outpatient Physical Therapy Services, LLC | Physical Therapist | Current |
Accepting new patients |
| Saco Bay Orthopaedic and Sports Physical Therapy, Inc. | Current |
Accepting new patients | |
| Saco Bay Orthopaedic and Sports Physical Therapy, Inc | Physical Therapist | Current | Accepting new patients |
Locations
34 Martin Ln
Belfast, ME 04915
Phone (207) 338-4117
42 Bucksport Rd
Ellsworth, ME 04605
Phone (207) 573-1609
11 Ocean St
Jonesport, ME 04649
Phone (207) 497-2363
400 North St
#2
Saco, ME 04072
Phone (207) 282-7121
111 Ossipee Trl E
Ste 1151
Standish, ME 04084
Phone (207) 642-3524
2500 Dallas Pkwy
Ste 410
Plano, TX 75093
Phone (940) 783-2760
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6328 | ME | Yes |
Addresses
Primary practice location
111 Ossipee TRL E Ste 1151
Standish, ME 04084-6421
Mailing address
3497 County Route 61
Andover, NY 14806-9515
Phone (607) 590-7728
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kamidon@sacobaypt.com | Direct |
Other providers in Standish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.