Individual provider Active NPI

Karen J Bailey, P.T.

  • Physical Therapist
  • Scarborough, ME
National Provider Identifier
1871688010
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1272 Issued in ME
Practice address
5 Millbrook Rd
Scarborough, ME 04074-9702
Phone
(207) 510-6500
Fax
(207) 510-6565
NPI assigned
Oct 4, 2006
Last updated
Mar 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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 PT1272 ME Primary

Addresses

Primary practice location

5 Millbrook Rd
Scarborough, ME 04074-9702

Mailing address

18 Skylark Rd
Portland, ME 04103-2016
Phone (207) 510-6500

Other identifiers 5

IdentifierTypeStateIssuer
3011201OtherAETNA/BB
044517OtherMEANTHEM BC/BS
650025318OtherPALMETTO GBA
11223425OtherCAQH
7533401OtherAETNA/KY, TX & CHICKERING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050427001079 ME Practitioner - Physical Therapist in Private Practice 0547209777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of New England, College of Osteo Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Performance Physical Therapy,LLCGroup PAC ID 5799701819, 4 clinicians

Practice addresses (Care Compare)

5 Millbrook Rd
Scarborough, ME 04074-9702
Phone (207) 510-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT1272MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance Physical Therapy,LLC Physical Therapist CurrentSince Sep 1, 2002 Accepting new patients

Locations

308 US Route 1
Ste E1
Scarborough, ME 04074
Phone (207) 303-3030

5 Millbrook Rd
Scarborough, ME 04074
Phone (207) 510-6500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1871688010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SKYLARK RD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032016",
            "telephone_number": "207-510-6500",
            "fax_number": "207-510-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MILLBROOK RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749702",
            "telephone_number": "207-510-6500",
            "fax_number": "207-510-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KAREN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT1272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/BB",
            "identifier": "3011201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "044517",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "650025318",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11223425",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/KY, TX & CHICKERING",
            "identifier": "7533401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.