Thomas Joseph Boutaugh, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT022319 Issued in PA

Practice address

63-65 W Church St.
Suite 71
Stevens, PA 17578

Phone

(717) 335-1016

NPI assigned

May 3, 2006

Last updated

Mar 31, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PHS Physical Therapy LLCGroup PAC ID 9234454851, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PHS Physical Therapy, LLC

  dba Select Physical Therapy

  • Physical Therapist
  • Camp Hill, PA
  • NPI 1912300096
  Medicare reassignment Care Compare group NPD
• Novacare Outpatient Rehabilitation East, Inc.

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Ligonier, PA
  • NPI 1487010583

  Physical Therapist

  Medicare reassignment NPD
• Novacare Outpatient Rehabilitation East, Inc.

  dba Novacare Rehabilitation

  • Rehabilitation Clinic/Center
  • Wyomissing, PA
  • NPI 1497367551
  NPD
• Novacare Outpatient Rehabilitation East Inc

  dba NovaCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Ferndale, MI
  • NPI 1245235191
  NPD
• Covey Physical Therapy

  • Physical Therapist
  • Hermon, ME
  • NPI 1144487471
  NPD (past)
• Sunbury Primary Care, P.a.

  dba Sunbury Physical and Occupational Therapy

  • Physical Therapist
  • Bangor, ME
  • NPI 1124113345
  NPD (past)
• Sunbury Primary Care, P.a.

  dba Sunbury Medical Assocaites

  • Family Medicine Physician
  • Bangor, ME
  • NPI 1437242294
  NPD (past)
• Thomas J Vanidestine Jr

  • Chiropractor
  • Bangor, ME
  • NPI 1487600011
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1811955115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 NORWAY DR",
            "city": "MOHNTON",
            "state": "PA",
            "postal_code": "195408743",
            "telephone_number": "207-659-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63-65 W CHURCH ST.",
            "address_2": "SUITE 71",
            "city": "STEVENS",
            "state": "PA",
            "postal_code": "17578",
            "telephone_number": "717-335-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTAUGH",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2423",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "100546",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7538245",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "248160000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas L Andersen, O.D.
• Cocalico Area Hearing Services, Inc.
• Renee Cornelius
• Meg Genea Cramer
• Ephrata Community Hospital (WellSpan Ephrata Community Hospital)
• Harry L. Eshbaugh, D.D.S.

• Physical Therapist in Stevens, PA
• Providers in Stevens, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.