Lisa Marie Anderson, PA-C
Individual provider Active NPI Physician Assistant · Augusta, ME
NPI 1366525826 · NPPES record last updated Nov 14, 2023
Key facts
- NPI
- 1366525826
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA1830 (ME)
- Practice address
- 10 Whitten Rd
Augusta, ME 04330-6019 - Phone
- (207) 466-2400
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pai Participant 7 PC
Practice addresses (Care Compare)
367 US Route 1
Suite 3S
Falmouth, ME 04105-1352
Phone (207) 962-1200
Hospital & facility affiliations
- Maine General Medical Center
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180917000701 | ME | Practitioner - Physician Assistant | 3274635560 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0003392 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainegeneral Medical Center | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Pai Participant 7 PC | Current |
Accepting new patients | |
| Mainegeneral Medical Center | Current |
Accepting new patients |
Locations
600 Center St
Auburn, ME 04210
Phone (207) 783-8951
35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639
10 Whitten Rd
Augusta, ME 04330
Phone (207) 466-2400
193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272
367 US Route 1
Ste 3S
Falmouth, ME 04105
Phone (207) 939-6789
149 North St
Waterville, ME 04901
Phone (207) 622-1959
950 Main St
Westbrook, ME 04092
Phone (207) 517-3800
111 New Hampshire Ave
Ste 2
Portsmouth, NH 03801
Phone (603) 319-4490
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
111 New Hampshire Ave
Portsmouth, NH 03801
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1830 | ME | Yes |
| Physician Assistant | 363A00000X | C0003392 | MD | |
| Medical Physician Assistant | 363AM0700X | C0003392 | MD |
Addresses
Primary practice location
10 Whitten Rd
Augusta, ME 04330-6019
Mailing address
360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700
Other practice location 1
301 St Paul Place
Dept of Medicine
Baltimore, MD 21202
Phone (410) 332-9694
Other names
- Lisa Marie Gourley
Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2023. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.