Individual provider Active NPI

Wesley Sulloway, PA-C

  • Surgical Physician Assistant
  • Biddeford, ME
National Provider Identifier
1598493884
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2426 Issued in ME
Practice address
46 Barra Rd Ste 103
Biddeford, ME 04005-9461
Phone
(207) 283-1126
Fax
(207) 294-3544
NPI assigned
Aug 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2426 ME Primary
Physician Assistant 363A00000X PA2426 ME

Addresses

Primary practice location

46 Barra Rd Ste 103
Biddeford, ME 04005-9461

Mailing address

46 Barra Rd Ste 103
Biddeford, ME 04005-9461
Phone (207) 283-1126

Other practice location 1

25A June St Ste 16
Sanford, ME 04073-2615
Phone (207) 324-1488

Other practice location 2

24 Miles Center Way
Damariscotta, ME 04543-4067
Phone (207) 563-1040

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
I20221110000495 ME Practitioner - Physician Assistant 1153798772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Biddeford, ME 04005-9422
Phone (207) 282-4270

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

25 A June St
Sanford, ME 04073-2642

46 Barra Rd
Suite 201202
Biddeford, ME 04005-9459
Phone (207) 282-3349

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2426MEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2022 Accepting new patients
Mainehealth CurrentSince Jul 1, 2025 Accepting new patients
Mainehealth CurrentSince Oct 1, 2022 Accepting new patients

Locations

46 Barra Rd
Ste 103
Biddeford, ME 04005
Phone (207) 283-1126

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

24 Miles Center Way
Damariscotta, ME 04543
Phone (207) 563-4250

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

25A June St
Ste 16
Sanford, ME 04073
Phone (207) 324-1488

Interoperability endpoints

  • Direct secure messaging: wsulloway557001@direct.mmc.mainehealth.org

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1598493884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 BARRA RD STE 103",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059461",
            "telephone_number": "207-283-1126",
            "fax_number": "207-294-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 BARRA RD STE 103",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059461",
            "telephone_number": "207-283-1126",
            "fax_number": "207-294-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25A June St Ste 16",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732615",
            "country_code": "US",
            "telephone_number": "207-324-1488",
            "fax_number": "207-490-5733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Miles Center Way",
            "address_purpose": "LOCATION",
            "city": "Damariscotta",
            "state": "ME",
            "postal_code": "045434067",
            "country_code": "US",
            "telephone_number": "207-563-1040",
            "fax_number": "207-810-2412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLOWAY",
        "first_name": "WESLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-12",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA2426",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.