Individual provider Active NPI

Rebecca Ann Rose, PA

  • Physician Assistant
  • Sanford, ME
National Provider Identifier
1235102336
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2196 Issued in ME
Practice address
25A June St Ste 11
Sanford, ME 04073-2642
Phone
(207) 490-7900
Fax
(207) 490-7969
NPI assigned
Feb 9, 2006
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2196 ME Primary
Physician Assistant 363A00000X 2385 NH

Addresses

Primary practice location

25A June St Ste 11
Sanford, ME 04073-2642

Mailing address

25A June St Ste 11
Sanford, ME 04073-2642
Phone (207) 490-7900

Other practice location 1

1976 White Mountain Hwy Ste 105
North Conway, NH 03860-5147
Phone (603) 356-4940

Other practice location 2

10 Goodall Dr Ste 900
East Waterboro, ME 04030-5233
Phone (207) 490-7505

Other practice location 3

2 Livewell Dr
Kennebunk, ME 04043-6762
Phone (207) 467-6900

Other practice location 4

655 Main St
Saco, ME 04072-1699
Phone (207) 294-5600

Other identifiers 2

IdentifierTypeStateIssuer
30332536MedicaidNH
0400503YPNH01OtherNHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050209000552 NH Practitioner - Physician Assistant 6002867884 Reassigns benefits to 1 organization
I20210623001702 ME Practitioner - Physician Assistant 6002867884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

10 Goodall Dr
Suite 900
East Waterboro, ME 04030-5233
Phone (207) 490-7760

1976 White Mountain Hwy
Suite 105
North Conway, NH 03860-5147
Phone (603) 356-4940

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

25 A June St
Sanford, ME 04073-2642

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0457NHMDOccupational Therapy Assistant
2385NHMDPediatric Occupational Therapist
457NHMDSpeech-Language Pathologist
PA2196MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jun 28, 2021 Accepting new patients
Mainehealth CurrentSince Jun 28, 2021 Accepting new patients
Mainehealth New Hampshire Ambulatory Care CurrentSince Nov 3, 2025 Accepting new patients

Locations

10 Goodall Dr
Ste 900
East Waterboro, ME 04030
Phone (207) 490-7505

2 Livewell Dr
Kennebunk, ME 04043
Phone (207) 467-6900

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

655 Main St
Saco, ME 04072
Phone (207) 283-1407

25A June St
Sanford, ME 04073
Phone (207) 324-4310

25A June St
Ste 11
Sanford, ME 04073
Phone (207) 282-3666

1976 White Mountain Hwy
Ste 105
North Conway, NH 03860
Phone (603) 356-4940

Interoperability endpoints

  • Direct secure messaging: rrose369622@direct.mmc.mainehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1235102336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25A JUNE ST STE 11",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732642",
            "telephone_number": "207-490-7900",
            "fax_number": "207-490-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25A JUNE ST STE 11",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732642",
            "telephone_number": "207-490-7900",
            "fax_number": "207-490-7969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1976 White Mountain Hwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "North Conway",
            "state": "NH",
            "postal_code": "038605147",
            "country_code": "US",
            "telephone_number": "603-356-4940",
            "fax_number": "603-371-3250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Goodall Dr Ste 900",
            "address_purpose": "LOCATION",
            "city": "East Waterboro",
            "state": "ME",
            "postal_code": "040305233",
            "country_code": "US",
            "telephone_number": "207-490-7505",
            "fax_number": "207-490-7529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Livewell Dr",
            "address_purpose": "LOCATION",
            "city": "Kennebunk",
            "state": "ME",
            "postal_code": "040436762",
            "country_code": "US",
            "telephone_number": "207-467-6900",
            "fax_number": "207-467-6921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 Main St",
            "address_purpose": "LOCATION",
            "city": "Saco",
            "state": "ME",
            "postal_code": "040721699",
            "country_code": "US",
            "telephone_number": "207-294-5600",
            "fax_number": "207-294-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2196",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30332536",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0400503YPNH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

Verify at the official NPI Registry.