Deidra Ouellette

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3925 Issued in ME

Practice address

2 Davis Point LN
Suite 1a
Cape Elizabeth, ME 04107-2620

Phone

(207) 767-9773

NPI assigned

Jun 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Deidra Pelletier Former name

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massabesic Health Resources PAGroup PAC ID 5395712137, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Massabesic Health Resources PA

  • Physical Therapist
  • Waterboro, ME
  • NPI 1316983257
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1689089328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DAVIS POINT LN",
            "address_2": "SUITE 1A",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041072620",
            "telephone_number": "207-767-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DAVIS POINT LN",
            "address_2": "SUITE 1A",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041072620",
            "telephone_number": "207-767-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "DEIDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT3925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIDRA",
            "last_name": "PELLETIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Mary Nicoll, LMSW-CC
• Sarah Nix, FNP
• Marjorie Hannah Norton, DPT
• Nutrition Solutions by Design, LLC
• Laura Olken O'Donnell, LCSW
• Tasha Lee Passmore
• Cassandra Pateneaude, FNP
• Amy Pelletier
• Alina Perez, PH.D.
• Jennifer Kress Pringle, RN

• Physical Therapist in Cape Elizabeth, ME
• Providers in Cape Elizabeth, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.