Ellen Grace Wise

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3080 Issued in ME

Practice address

193 Bath Rd
Brunswick, ME 04011-2607

Phone

(207) 424-2272

NPI assigned

Mar 9, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1144176538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 BATH RD",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112607",
            "telephone_number": "207-424-2272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9801 Belvedere Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Palm Beach",
            "state": "FL",
            "postal_code": "334113640",
            "country_code": "US",
            "telephone_number": "561-273-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "ELLEN",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA3080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Brann Wilson, LCSW
• Santana M Wilson, LATC
• William R Wink, CRNA
• Kathleen S. Winn, D.M.D.
• Wise Star Counseling LLC
• Lynn Marie Witten, RN-BC
• Christopher M Wnek, D.M.D.
• Donald R Woloszyn, MD
• Amos Makaala Wolven, LMSW - CC
• Erica Ann Wonson, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.