Individual provider Active NPI

Amy Lee Caldwell, PA-C

  • Medical Physician Assistant
  • Skowhegan, ME
National Provider Identifier
1598066409
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA305 Issued in ME
Practice address
46 Fairview Ave
Skowhegan, ME 04976-1481
Phone
(207) 474-5121
Fax
(207) 858-2415
NPI assigned
Nov 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA305 ME
Medical Physician Assistant 363AM0700X PA305 ME Primary
Physician Assistant 363A00000X PA001243 ME

Addresses

Primary practice location

46 Fairview Ave
Skowhegan, ME 04976-1481

Mailing address

46 Fairview Ave
Skowhegan, ME 04976-1481
Phone (207) 474-5121

Other identifiers 1

IdentifierTypeStateIssuer
1598066409MedicaidME

Other names 1

  • Amy Lee Hanscom 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
I20110119000703 ME Practitioner - Physician Assistant 5395924633 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

Practice addresses (Care Compare)

46 Fairview Ave
Skowhegan, ME 04976-1481

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA001243MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redington-Fairview General Hospital CurrentSince Sep 12, 2012 Accepting new patients
Redington-Fairview General Hospital CurrentSince Sep 12, 2012 Accepting new patients

Locations

46 Fairview Ave
Skowhegan, ME 04976
Phone 2074745121293

Organizations & group practices 2

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 1

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": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1598066409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-5121",
            "fax_number": "207-858-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA305",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA305",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA001243",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598066409",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HANSCOM",
            "middle_name": "LEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.