Individual provider Active NPI

Letha Kowalsky, PT

  • Physical Therapist
  • Brunswick, ME
National Provider Identifier
1669868063
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2103 Issued in ME
Practice address
29 Maurice Dr
Brunswick, ME 04011-3270
Phone
(207) 725-7495
Fax
(207) 725-1350
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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 PT2103 ME Primary

Addresses

Primary practice location

29 Maurice Dr
Brunswick, ME 04011-3270

Mailing address

29 Maurice Dr
Brunswick, ME 04011-3270
Phone (207) 725-7495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220628002706 ME Practitioner - Physical Therapist in Private Practice 5799164372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2103MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Therapy Outpatient Services of Me, LLC Physical Therapist CurrentSince Mar 24, 2022 Accepting new patients
Preferred Therapy Outpatient Services of Me, LLC Physical Therapist CurrentSince Mar 24, 2022 Accepting new patients

Locations

850 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 610-0400

30 Community Dr
Camden, ME 04843
Phone (207) 230-6100

Organizations & group practices 2

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1669868063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MAURICE DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113270",
            "telephone_number": "207-725-7495",
            "fax_number": "207-725-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MAURICE DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113270",
            "telephone_number": "207-725-7495",
            "fax_number": "207-725-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKY",
        "first_name": "LETHA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.