MEDICARE: PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	225XH1200X	Hand Occupational Therapist
3	225100000X	Physical Therapist
4	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1306165824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD

Provider Business Mailing Address
First Line	:	PO BOX 34990
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-0627
Country	:	US
Telephone Number	:	610-359-5640
Fax Number	:

Provider Business Practice Location Address
First Line	:	1161 MCDERMOTT DR STE 250
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4064
Country	:	US
Telephone Number	:	484-356-9401
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	CHRISTINA REALE
Credential	:
Telephone Number	:	610-359-5672

Provider Enumeration Date	:	05/24/2010
Last Update Date	:	01/16/2026

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