Individual provider Active NPI

Sheena E Whittaker, MD

  • Pediatrics Physician
  • Ellsworth, ME
National Provider Identifier
1174562078
Registry record updated Apr 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
016613 Issued in ME
Practice address
32 Resort Way
Maine Coast Pediatrics
Ellsworth, ME 04605-1717
Phone
(207) 664-7744
Fax
(207) 664-7724
NPI assigned
Jun 6, 2006
Last updated
Apr 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 016613 ME Primary

Addresses

Primary practice location

32 Resort Way
Maine Coast Pediatrics
Ellsworth, ME 04605-1717

Mailing address

50 Union St
Maine Coast Pediatrics
Ellsworth, ME 04605-1586
Phone (207) 664-7744

Other identifiers 1

IdentifierTypeStateIssuer
416180099MedicaidME

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915000694 ME Practitioner - Pediatric Medicine 6002883360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
George Washington University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

32 Resort Way
Maine Coast Pediatrics
Ellsworth, ME 04605-1717
Phone (207) 664-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Coast Regional Health Facilities Pediatrics CurrentSince Sep 1, 2004 Accepting new patients
Maine Coast Regional Health Facilities CurrentSince Sep 1, 2004 Accepting new patients
Maine Coast Physician Affiliates Past Accepting new patients

Locations

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

50 Union St
Ste 3200
Ellsworth, ME 04605
Phone (207) 664-5650

32 Resort Way
Ellsworth, ME 04605
Phone (207) 664-5480

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271894400000",
    "number": "1174562078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 UNION ST",
            "address_2": "MAINE COAST PEDIATRICS",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051586",
            "telephone_number": "207-664-7744",
            "fax_number": "207-664-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 RESORT WAY",
            "address_2": "MAINE COAST PEDIATRICS",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051717",
            "telephone_number": "207-664-7744",
            "fax_number": "207-664-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "SHEENA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "016613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416180099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.