Individual provider Active NPI

Elizabeth A Teague, PA-C

  • Medical Physician Assistant
  • Augusta, ME
National Provider Identifier
1255647418
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1225 Issued in ME
Practice address
361 Old Belgrade Rd
Augusta, ME 04330-8058
Phone
(207) 621-6100
Fax
(207) 621-6102
NPI assigned
Aug 26, 2010
Last updated
Dec 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1225 ME Primary

Addresses

Primary practice location

361 Old Belgrade Rd
Augusta, ME 04330-8058

Mailing address

361 Old Belgrade Rd
Augusta, ME 04330-8058
Phone (207) 621-6100

Other identifiers 1

IdentifierTypeStateIssuer
435979299MedicaidME

Other names 1

  • Elizabeth A Connelly Former name

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
I20101006000023 ME Practitioner - Physician Assistant 6901098250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901
Phone (207) 872-1000

35 Medical Ctr Pkwy
Augusta, ME 04330-8160
Phone (207) 621-1000

361 Old Belgrade Rd
Augusta, ME 04330-8058
Phone (207) 621-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1225MEMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Oct 21, 2015 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 26, 2012 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 26, 2012 Accepting new patients
Redington-Fairview General Hospital CurrentSince Oct 21, 2015 Accepting new patients
Seaport Family Practice Past Accepting new patients

Locations

361 Old Belgrade Rd
Augusta, ME 04330
Phone (207) 621-6100

46 Fairview Ave
Ste 224
Skowhegan, ME 04976
Phone (207) 858-2119

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: elizabeth.teague@ronc.direct.rfgh.net

Organizations & group practices 5

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1255647418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 OLD BELGRADE RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308058",
            "telephone_number": "207-621-6100",
            "fax_number": "207-621-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 OLD BELGRADE RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308058",
            "telephone_number": "207-621-6100",
            "fax_number": "207-621-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA1225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435979299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CONNELLY",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.