Amanda Dahlgren, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Sanford, ME
NPI 1720693138 · NPPES record last updated Nov 15, 2023
Key facts
- NPI
- 1720693138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP231098 (ME)
- Practice address
- 1420 Main St
Sanford, ME 04073-3680 - Phone
- (207) 850-5744
- NPI assigned
- Sep 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Convenientmd - FFS UC LLC
Practice addresses (Care Compare)
14 Webb PL
Dover, NH 03820-2467
Phone (603) 742-7900
543 Broadway
Bangor, ME 04401-3337
Phone (207) 922-1300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ME, NH
- 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 |
|---|---|---|---|---|
| I20230320001589 | ME | Practitioner - Nurse Practitioner | 4284008954 | Reassigns benefits to 1 organization |
| I20240521003064 | NH | Practitioner - Nurse Practitioner | 4284008954 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090946-23 | NH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Past | Accepting new patients |
Locations
600 Center St
Auburn, ME 04210
Phone (207) 783-8951
543 Broadway
Bangor, ME 04401
Phone (207) 922-1300
193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272
1420 Main St
Sanford, ME 04073
Phone (207) 850-5744
950 Main St
Westbrook, ME 04092
Phone (207) 517-3800
3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700
14 Webb Pl
Dover, NH 03820
Phone (603) 742-7900
111 New Hampshire Ave
Ste 2
Portsmouth, NH 03801
Phone (603) 319-4490
111 New Hampshire Ave
Portsmouth, NH 03801
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 090946-23 | NH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Nurse Practitioner | 363LF0000X | CNP231098 | ME | Yes |
Addresses
Primary practice location
1420 Main St
Sanford, ME 04073-3680
Mailing address
360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN72395 | Other | ME | MAINE STATE BOARD OF NURSING |
| 090946-23 | Other | NH | STATE OF NEW HAMPSHIRE BOARD OF NURSING |
| CNP231098 | Other | ME | MAINE STATE BOARD OF NURSING |
Other providers in Sanford, ME
- Alyssa Rose Currier
- Brittanie Anne Curry
- Curtis Lake Christian Church
- CVS State Capital LLC
- Elizabeth C Cyr
- Chelsea Lynn Daigle
- Jeff W Daigle
- Daniel P Roy
- Betsey Marie Davis
- Kathleen Alicia Delewski
All providers in Sanford, ME · Family Nurse Practitioner in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 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.