Eastport Health Care, Inc
A Medicare group practice based in Eastport, ME: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 3577592880), with 24 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 3577592880
- Provider type
- MDPP Supplier - in-Person MDPP Supplier, Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
- Enrolled in
- ME
- Enrollments
- 4
- Group size
- 12 clinicians
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Practice locations
- 5
Enrollment records 4
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20050808000284 | ME | Part B Supplier - Clinic/Group Practice | 1093752917 |
| O20110324000512 | ME | Part A Provider - Federally Qualified Health Center (FQHC) | 1093752917 |
| O20230901001745 | ME | Part A Provider - Federally Qualified Health Center (FQHC) | 1295020691 |
| O20180503002570 | ME | MDPP Supplier - in-Person MDPP Supplier | 1093752917 |
NPIs in this group 2
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Eastport Health Care, Inc.
- Federally Qualified Health Center (FQHC)
- Eastport, ME
- NPI 1093752917
-
Eastport Health Care, Inc.
- Federally Qualified Health Center (FQHC)
- Machias, ME
- NPI 1295020691
Practice locations
- Eastport, ME3
- Machias, ME2
Clinicians 24
Clinicians who reassign their Medicare benefits to this group (24) or whom Care Compare lists as members (12).
-
Bryan Franklin Armstrong, P-LCSW, P-LCAS
- Clinical Social Worker
- Charlotte, NC
- NPI 1245554617
-
John F Cassidy IV, PA-C
- Physician Assistant
- Eastport, ME
- NPI 1891890166
-
Laurie A Churchill, MD
- Family Medicine Physician
- Calais, ME
- NPI 1962463224
-
Jennifer Joy Doucette, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Eastport, ME
- NPI 1437090065
-
Abhay Arun Ektare
- General Practice Dentistry
- Eastport, ME
- NPI 1831281567
-
Robin Michele Gerry, LCSW-R
- Clinical Social Worker
- Machias, ME
- NPI 1306903398
-
Albert Frederick Hartman Jr., MD
- Family Medicine Physician
- Lewiston, ME
- NPI 1790110237
-
Lisa Jacobs, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Bangor, ME
- NPI 1568554186
-
Peter Josiah Knowles, D.C.
- Chiropractor
- Machias, ME
- NPI 1992847180
-
Marcia Ann Kyle, RD, LD, CDE
- Registered Dietitian
- Rockport, ME
- NPI 1932430568
-
Kelly Leslie, APRN-FNP-C
- Family Nurse Practitioner
- Woodward, OK
- NPI 1447896147
-
Susan L. Luthin, M.D.
- Family Medicine Physician
- Dover Foxcroft, ME
- NPI 1356383962
-
Sandra Manship, APRN-CNP
- Family Nurse Practitioner
- Machias, ME
- NPI 1215368881
-
Nima Moghaddas, DPM
- Primary Podiatric Medicine Podiatrist
- Calais, ME
- NPI 1376625426
-
Ann E. O'Brien, APNP
- Psychiatric/Mental Health Nurse Practitioner
- Eastport, ME
- NPI 1609908052
-
Steve Parker, PA
- Medical Physician Assistant
- Eastport, ME
- NPI 1528191715
-
Robert W Phares, MD
- Family Medicine Physician
- Oakland, MD
- NPI 1083666598
-
Jordan S Porter, DNP
- Family Nurse Practitioner
- Scarborough, ME
- NPI 1285286591
-
William B Richardson, MD
- Family Medicine Physician
- Eastport, ME
- NPI 1457409617
-
Pradheep J Shanker, M.D.
- Body Imaging Physician
- Columbus, OH
- NPI 1457399818
-
Rebecca Starr
- Physician Assistant
- Machias, ME
- NPI 1790452563
-
Elliott Jay Wagner, M.D.
- Diagnostic Radiology Physician
- Beverly Hills, CA
- NPI 1558312579
-
Laura Malone Wakeman, LCSW-C
- Clinical Social Worker
- Machias, ME
- NPI 1053921437
-
William Keith White, PA-C
- Physician Assistant
- Cartersville, GA
- NPI 1649286428
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.