Amy M Patrick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1397 Issued in ME

Practice address

22 Bramhall St
Portland, ME 04102-3134

Phone

(207) 662-2381

Fax

(207) 662-6226

NPI assigned

Sep 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apatrick761601@direct.ochin.org
• Direct secure messaging: amy.patrick.p1@direct.cmcentersinc.nextgenshare.com

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.

• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169

  CA

  Medicare reassignment NPD
• Community Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Esparto, CA
  • NPI 1588729180

  CA

  Medicare reassignment
• Community Medical Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1891529061
  NPD
• Community Medical Centers, Inc.

  • Clinic/Center
  • Stockton, CA
  • NPI 1669720157
  NPD

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1730439746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 RIVERSIDE ST",
            "address_2": "SUITE 6B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031073",
            "telephone_number": "207-661-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2381",
            "fax_number": "207-662-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4474",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA329",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Thomas Patregnani, MD
• Monica Chen Patregnani, CPNP-AC
• Patricia Duffett Psychotherapy, LLC
• Patricia Proulx-Lough Counseling, PLLC
• Carey Patrick Wertz, LCPC
• Kelsey Patrick, LCSW
• Michelle Patrick, MT
• Kathleen Elizabeth Patten, DNAP, APRN, CRNA
• Katherine L Patterson, MSW
• Monique L Patterson, CRNA

• All providers in Portland, ME
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.