Active NPI
Amy L. Barraclough, PA-C
- Physician Assistant
- Portland, ME
National Provider Identifier
1770533713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1980
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-2381
- NPI assigned
- May 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1238 | WI | |
| Physician Assistant | 363A00000X | 1980 | ME | Primary |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700
Other practice location 1
191 Marginal Way
Portland, ME 04101-3387
Phone (207) 517-3838
Other practice location 2
1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42996500 | Medicaid | WI |
Other names 1
- Amy L. Dennis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
- Mainehealth Pen Bay Hospital
- Mainehealth Maine Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1980 | ME | MD | Physician Assistant |
| 1238 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
600 Center St
Auburn, ME 04210
Phone (207) 783-8951
193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
191 Marginal Way
Portland, ME 04101
Phone (207) 517-3838
950 Main St
Westbrook, ME 04092
Phone (207) 517-3800
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
111 New Hampshire Ave
Portsmouth, NH 03801
Interoperability endpoints
- abarraclough272220@direct.mmc.mainehealth.org
Organizations & group practices 7
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Urgent Care Clinic/Center
- Ellsworth, ME
- NPI 1780375220
-
- Urgent Care Clinic/Center
- Westbrook, ME
- NPI 1093406530
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Surgery Physician
- Portland, ME
- NPI 1376981993
-
- Urgent Care Clinic/Center
- Sturbridge, MA
- NPI 1386526192
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1770533713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 US HIGHWAY 1 BYP UNIT 102",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038017105",
"telephone_number": "603-410-6700",
"fax_number": "603-319-8308"
},
{
"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"
}
],
"practiceLocations": [
{
"address_1": "191 Marginal Way",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041013387",
"country_code": "US",
"telephone_number": "207-517-3838",
"fax_number": "207-517-3820",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1240 Big Jack Rd",
"address_purpose": "LOCATION",
"city": "Platteville",
"state": "WI",
"postal_code": "538188902",
"country_code": "US",
"telephone_number": "608-348-6266",
"fax_number": "608-342-5600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARRACLOUGH",
"first_name": "AMY",
"middle_name": "L.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "1238",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "1980",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42996500",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMY",
"last_name": "DENNIS",
"middle_name": "L.",
"credential": "P.A",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.