Individual provider Active NPI

Sarah Patricia Pelletier, CNP

  • Family Nurse Practitioner
  • Fort Kent, ME
National Provider Identifier
1417434804
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP181192 Issued in ME
Practice address
12 Bolduc Ave
Fort Kent, ME 04743-1602
Phone
(207) 834-3971
Fax
(207) 834-3837
NPI assigned
Jul 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP181192 ME Primary

Addresses

Primary practice location

12 Bolduc Ave
Fort Kent, ME 04743-1602

Mailing address

12 Bolduc Ave
Fort Kent, ME 04743-1602
Phone (207) 834-3971

Other identifiers 1

IdentifierTypeStateIssuer
CNP181192OtherMEMAINE STATE BOARD OF NURSING

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
I20180925001023 ME Practitioner - Nurse Practitioner 4688925092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fish River Rural HealthGroup PAC ID 3577531953, 21 clinicians

Practice addresses (Care Compare)

12 Bolduc Ave
Fort Kent, ME 04743-1602
Phone (207) 444-5973

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.42 of 100Reported as group
Quality
52.16
Promoting interoperability
94
Improvement activities
40
Cost
67.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP181192MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Maine Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Fish River Rural Health CurrentSince Oct 1, 2018 Accepting new patients
Northern Maine Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Fish River Rural Health CurrentSince Oct 1, 2018 Accepting new patients

Locations

10 Carter St
Eagle Lake, ME 04739
Phone (207) 444-5973

12 Bolduc Ave
Fort Kent, ME 04743
Phone (207) 834-3012

3 Mountainview Dr
Fort Kent, ME 04743
Phone (207) 834-1573

194 E Main St
Fort Kent, ME 04743
Phone (207) 834-3101

Interoperability endpoints

  • Direct secure messaging: spelletie7@yourcarecommunity.org
  • Direct secure messaging: sarah.pelletier.1@10077.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1417434804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431602",
            "telephone_number": "207-834-3971",
            "fax_number": "207-834-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431602",
            "telephone_number": "207-834-3971",
            "fax_number": "207-834-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "SARAH",
        "middle_name": "PATRICIA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP181192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE STATE BOARD OF NURSING",
            "identifier": "CNP181192",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Kent, ME

Sources for this page

Verify at the official NPI Registry.