Ellen M Anderson, DPM
Individual provider Active NPI Podiatrist · Dover Foxcroft, ME
NPI 1104928464 · NPPES record last updated Feb 5, 2015
Key facts
- NPI
- 1104928464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- POD155 (ME)
- Practice address
- 839 W Main St
Dover Foxcroft, ME 04426-1334 - Phone
- (207) 564-2536
- Fax
- (207) 564-8581
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Temple University School of Podiatric Medicine, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sebasticook Family Doctors
Practice addresses (Care Compare)
118 Moosehead TRL
Suite 5
Newport, ME 04953-4056
Phone (207) 368-5189
29 Church St
Dexter, ME 04930-1320
Phone (207) 924-5200
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050830000151 | ME | Practitioner - Podiatry | 7911938972 |
Reassigns benefits to 1 organization Practice locations: Dover-Foxcroft, ME |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD155 | ME | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sebasticook Family Doctors | Current | Accepting new patients | |
| Sebasticook Family Doctors | Current |
Accepting new patients | |
| Sebasticook Family Doctors | Current |
Accepting new patients |
Locations
29 Church St
Dexter, ME 04930
Phone (207) 487-4016
291 Williams Rd
Newport, ME 04953
Phone (207) 355-3508
118 Moosehead Trl
Ste 5
Newport, ME 04953
Phone (207) 368-4213
55 Fletcher Dr
Palmyra, ME 04965
Phone (207) 368-5189
Interoperability endpoints
- ellen.andersondpm.p1@direct.hhcme.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | POD155 | ME | Yes |
Addresses
Primary practice location
839 W Main St
Dover Foxcroft, ME 04426-1334
Mailing address
PO Box 327
Dover-Foxcroft, ME 04426-0327
Phone (207) 564-2536
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112960000 | Medicaid | ME |
Other providers in Dover Foxcroft, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.