Nicholas D Pennell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R049269 Issued in ME

Practice address

1321 Washington Ave
301
Portland, ME 04103-3636

Phone

(207) 780-6565

Fax

(207) 878-6565

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tapestry Telehealth PLLCGroup PAC ID 4789942335, 80 clinicians

Vantage Healthcare IncGroup PAC ID 0042751430, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vantage Healthcare Inc

  • Internal Medicine Physician
  • Kittery, ME
  • NPI 1386474625
  Medicare reassignment Care Compare group NPD
• Tapestry Telehealth PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1992215446

  ME

  Medicare reassignment Care Compare group
• Impact Health Me, LLC

  • Nurse Practitioner
  • Yarmouth, ME
  • NPI 1518432574
  Medicare reassignment NPD
• Maine Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Biddeford, ME
  • NPI 1326156605
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1053368993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "address_2": "301",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033636",
            "telephone_number": "207-780-6565",
            "fax_number": "207-878-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "address_2": "301",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033636",
            "telephone_number": "207-780-6565",
            "fax_number": "207-878-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "NICHOLAS",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R049269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30347108",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433046299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yordan Penev, MD
• Kathryn E. Penge, SP
• Anna Victoria Penkiunas
• Katelyn Penna Berube, M.S. CCC-SLP
• Kevin Pennell, L.M.T.
• Keating W Pepper, DO
• Paloma Alejandra Peraza
• Gregory Benjamin Perchik, LCSW
• Tessa Simone Peredy, DO
• Peregrine Corporation

• Family Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.