Individual provider Active NPI

Jerusha Peram, PT

  • Physical Therapist
  • Kennebunk, ME
National Provider Identifier
1720861966
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7464 Issued in ME
Practice address
65 Portland Rd Ste 5
Kennebunk, ME 04043-6742
Phone
(207) 985-6181
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02196100 NJ
Physical Therapist 225100000X PT7464 ME Primary
Physical Therapist 225100000X PT44221 FL
Physical Therapist 225100000X CP048807T NH

Addresses

Primary practice location

65 Portland Rd Ste 5
Kennebunk, ME 04043-6742

Mailing address

37 Main St
Conway, NH 03818-6166
Phone (603) 447-2533

Other practice location 1

7410 Boynton Beach Blvd Ste A11
Boynton Beach, FL 33437-6157
Phone (561) 731-0163

Other practice location 2

37 Main St
Conway, NH 03818-6166
Phone (603) 447-2533

Other practice location 3

1077 Route 34 Ste M
Aberdeen, NJ 07747-2151
Phone (732) 970-7882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231023000926 NJ Practitioner - Physical Therapist in Private Practice 4284080656 Reassigns benefits to 1 organization
I20250916000447 NH Practitioner - Physical Therapist in Private Practice 4284080656

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proform Physical Therapy LLCGroup PAC ID 9436383114, 18 clinicians
Saco Bay Orthopaedic and Sports Physical Therapy IncGroup PAC ID 9537069265, 137 clinicians

Practice addresses (Care Compare)

1077 State Route 34
Suite M
Aberdeen, NJ 07747-2151
Phone (732) 970-7882

65 Portland Rd
Suite 5
Kennebunk, ME 04043-6742
Phone (207) 985-6181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT44221FLMDPhysical Therapist
CP048807TNHMDPhysical Therapist
40QA02196100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proform Physical Therapy LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Proform Physical Therapy LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. Physical Therapist Current Accepting new patients

Locations

37 Main St
Conway, NH 03818
Phone (603) 447-2533

75 Newport Rd
Unit 4
New London, NH 03257
Phone (603) 526-2781

510 State Route 18
East Brunswick, NJ 08816
Phone (732) 554-8330

1077 State Route 34
Ste M
Matawan, NJ 07747
Phone (732) 970-7882

2665 Highway 516
Old Bridge, NJ 08857
Phone (732) 952-8826

Organizations & group practices 3

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1720861966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 MAIN ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186166",
            "telephone_number": "603-447-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PORTLAND RD STE 5",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436742",
            "telephone_number": "207-985-6181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7410 Boynton Beach Blvd Ste A11",
            "address_purpose": "LOCATION",
            "city": "Boynton Beach",
            "state": "FL",
            "postal_code": "334376157",
            "country_code": "US",
            "telephone_number": "561-731-0163",
            "fax_number": "561-731-1886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Main St",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "NH",
            "postal_code": "038186166",
            "country_code": "US",
            "telephone_number": "603-447-2533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1077 Route 34 Ste M",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "NJ",
            "postal_code": "077472151",
            "country_code": "US",
            "telephone_number": "732-970-7882",
            "fax_number": "732-970-7883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERAM",
        "first_name": "JERUSHA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02196100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7464",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT44221",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "CP048807T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.