Individual provider Active NPI

Elyssa Denault, PA-C

  • Physician Assistant
  • Portland, ME
National Provider Identifier
1053271585
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2997 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-4618
Fax
(207) 662-6254
NPI assigned
Nov 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2997 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4618

Other practice location 1

181 Main St
Norway, ME 04268-5664
Phone (207) 743-5933

Other practice location 2

25 June St
Sanford, ME 04073-2621
Phone (207) 324-4310

Other practice location 3

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113002271 ME Practitioner - Physician Assistant 6406332022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

181 Main St
Norway, ME 04268-5664
Phone (207) 743-5933

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2997MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Feb 16, 2026 Accepting new patients
Mainehealth CurrentSince Feb 16, 2026 Accepting new patients
Mainehealth CurrentSince Feb 16, 2026 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

181 Main St
Norway, ME 04268
Phone (207) 743-5933

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

25 June St
Sanford, ME 04073
Phone (207) 324-4310

Organizations & group practices 4

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

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1053271585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Main St",
            "address_purpose": "LOCATION",
            "city": "Norway",
            "state": "ME",
            "postal_code": "042685664",
            "country_code": "US",
            "telephone_number": "207-743-5933",
            "fax_number": "207-743-1566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 June St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732621",
            "country_code": "US",
            "telephone_number": "207-324-4310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7937",
            "fax_number": "207-283-7018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENAULT",
        "first_name": "ELYSSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.