Individual provider Active NPI

Elias Pasquerillo, PA

  • Physician Assistant
  • Saco, ME
National Provider Identifier
1184403750
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2934 Issued in ME
Practice address
13 Industrial Park Rd
Saco, ME 04072-1804
Phone
(207) 283-8800
Fax
(207) 613-2566
NPI assigned
Sep 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2934 ME Primary

Addresses

Primary practice location

13 Industrial Park Rd
Saco, ME 04072-1804

Mailing address

13 Industrial Park Rd
Saco, ME 04072-1804
Phone (207) 283-8800

Other practice location 1

716 Stevens Ave
Hersey Hall Rm 108
Portland, ME 04103-2656
Phone (207) 221-4225

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104003389 ME Practitioner - Physician Assistant 9638669195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

193 Bath Rd
Brunswick, ME 04011-2607
Phone (207) 424-2272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2934MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC Current Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Sep 16, 2025 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Sep 16, 2025 Accepting new patients

Locations

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272

235 High St
Ellsworth, ME 04605
Phone (207) 412-5200

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1184403750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 INDUSTRIAL PARK RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721804",
            "telephone_number": "207-283-8800",
            "fax_number": "207-613-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 INDUSTRIAL PARK RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721804",
            "telephone_number": "207-283-8800",
            "fax_number": "207-613-2566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 Stevens Ave",
            "address_2": "Hersey Hall Rm 108",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041032656",
            "country_code": "US",
            "telephone_number": "207-221-4225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASQUERILLO",
        "first_name": "ELIAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.