Active NPI
Tammy Anne Pellegrino, OT
- Occupational Therapist
- Bangor, ME
National Provider Identifier
1710193040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT519
- Practice address
- 1 Cumberland PL
Suite 108
Bangor, ME 04401-5083 - Phone
- (207) 900-9000
- Fax
- (207) 945-8645
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
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.
-
- Home Health Agency
- Hampden, ME
- NPI 1538362314
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT519 | ME | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gentiva Health Services | Past | Accepting new patients |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT519 | ME | Primary |
Addresses
Primary practice location
1 Cumberland PL
Suite 108
Bangor, ME 04401-5083
Mailing address
PO Box 3143
Brewer, ME 04412-3143
NPI Registry JSON
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710193040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3143",
"city": "BREWER",
"state": "ME",
"postal_code": "044123143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CUMBERLAND PL",
"address_2": "SUITE 108",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015083",
"telephone_number": "207-900-9000",
"fax_number": "207-945-8645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLEGRINO",
"first_name": "TAMMY",
"middle_name": "ANNE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.