Individual provider Active NPI

Michele Delisle, OTR

  • Occupational Therapist
  • Portland, ME
National Provider Identifier
1871751941
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
ME 349999 Issued in ME
Practice address
1133 Washington Ave
Portland, ME 04103-3629
Phone
(207) 797-0600
Fax
(207) 797-8659
NPI assigned
May 27, 2008
Last updated
May 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X ME 349999 ME Primary

Addresses

Primary practice location

1133 Washington Ave
Portland, ME 04103-3629

Mailing address

1133 Washington Ave
Portland, ME 04103-3629
Phone (207) 797-0600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090304000241 ME Practitioner - Occupational Therapist in Private Practice 9436215183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Motion Physical Therapy LLCGroup PAC ID 7416926704, 57 clinicians

Practice addresses (Care Compare)

185 Ocean St
South Portland, ME 04106-3600
Phone (207) 799-8226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ME 349999MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Me LLC Occupational Therapist CurrentSince Apr 1, 2022 Accepting new patients
Back in Motion Physical Therapy, LLC CurrentSince Jan 3, 2023 Accepting new patients
Coastal Rehab, LLC Occupational Therapist CurrentSince Feb 17, 2009 Accepting new patients

Locations

2 Davis Point Ln
Unit 1A
Cape Elizabeth, ME 04107
Phone (207) 767-9773

94 Main St
Gorham, ME 04038
Phone (207) 839-5225

600 Commerce Dr
Scarborough, ME 04074
Phone (207) 730-6781

185 Ocean St
South Portland, ME 04106
Phone (207) 799-8226

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, 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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1871751941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033629",
            "telephone_number": "207-797-0600",
            "fax_number": "207-797-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033629",
            "telephone_number": "207-797-0600",
            "fax_number": "207-797-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "MICHELE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "ME 349999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.