Patricia A Elliott, MD
Individual provider Active NPI Family Medicine Physician · Old Town, ME
NPI 1275638546 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1275638546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 012193 (ME)
- Practice address
- 242 Brunswick St
Old Town, ME 04468 - Phone
- (207) 827-6128
- Fax
- (207) 827-5533
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221006001537 | ME | Practitioner - Internal Medicine | 7416906417 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012193 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current |
Accepting new patients | |
| Mainehealth | Current |
Accepting new patients |
Locations
181 Franklin Health Cmns
Farmington, ME 04938
Phone (207) 778-3326
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- patricia.elliott@hca6.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 012193 | ME | Yes |
Addresses
Primary practice location
242 Brunswick St
Old Town, ME 04468
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 293680099 | Medicaid | ME |
Other providers in Old Town, ME
- Jolene R Driver
- Amanda Dubois
- Jessica Dubois
- Kaitlyn Dunham
- Alexandria Durland
- Elm Enterprises
- Jamie L Emerson
- Celine Ferland
- Fit Physical Therapy and Consulting Services, LLC
- Charlotte Fitzgerald
All providers in Old Town, ME · Family Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.