Individual provider Active NPI

Andrea T Tomaselli, PT, MSPT

  • Physical Therapist
  • Brunswick, ME
National Provider Identifier
1780822353
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2616 Issued in ME
Practice address
142 Neptune Dr
Brunswick, ME 04011-2882
Phone
(860) 610-0400
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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 PT2616 ME Primary

Addresses

Primary practice location

142 Neptune Dr
Brunswick, ME 04011-2882

Mailing address

PO Box 949
Brunswick, ME 04011-0949

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT2616MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayonne Physical Therapy Inc Physical Therapist PastSince May 8, 2020 Accepting new patients
Pelican Sports and Rehabilitation, Inc Physical Therapist PastSince Jul 19, 2016 Accepting new patients
Bayonne Physical Therapy Inc Physical Therapist Past Accepting new patients

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": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1780822353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040110949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 NEPTUNE DR",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112882",
            "telephone_number": "860-610-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASELLI",
        "first_name": "ANDREA",
        "middle_name": "T",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2616",
            "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 Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.