Ellen N. Medrano, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA428 Issued in ME

Practice address

180 Church Hill Rd Ste 1
Leeds, ME 04263-3418

Phone

(207) 524-3501

Fax

(207) 524-2093

NPI assigned

Mar 19, 2007

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Female

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 1

Other names 1

• Ellen N Daggett-Medrano Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

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.

• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  ME

  Medicare reassignment
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  ME

  Medicare reassignment
• Central Maine Medical Center

  dba CMMC Specialty Pharmacy

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD
• Wiscasset Family Health

  • Family Medicine Physician
  • Wiscasset, ME
  • NPI 1235679838
  NPD
• Clearchoicemd Primary Care PLLC

  • Family Medicine Physician
  • Saint Albans, VT
  • NPI 1326582529
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1083738736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CHURCH HILL RD STE 1",
            "city": "LEEDS",
            "state": "ME",
            "postal_code": "042633418",
            "telephone_number": "207-524-3501",
            "fax_number": "207-524-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CHURCH HILL RD STE 1",
            "city": "LEEDS",
            "state": "ME",
            "postal_code": "042633418",
            "telephone_number": "207-524-3501",
            "fax_number": "207-524-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "ELLEN",
        "middle_name": "N.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083738736",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "DAGGETT-MEDRANO",
            "middle_name": "N",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathie Jane Greear, RRT/CPFT
• Diane Handler, PA
• Sharon S Hathaway, LD
• Olivia G. June, PA-C
• Anna D Mead, FNP
• Philip A Meher, LCMHC, LCPC
• Elena C Muehter, APRN
• NR Maine LLC
• Brianna A Palmer, PMHNP-BC
• Peggy Berlucchi

• Physician Assistant in Leeds, ME
• Providers in Leeds, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.