Alicia M Sanborn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1964 Issued in ME

Practice address

21 Enterprise Dr
Augusta, ME 04330-7894

Phone

(207) 621-7550

Fax

(207) 621-7551

NPI assigned

Aug 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alicia M Blank Former name

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Merit-based Incentive Payment System (MIPS)

Final score

86.22 of 100Reported as group

Quality

75.39

Promoting interoperability

84

Improvement activities

40

Cost

75.32

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aliciasanborn@mgh.allscriptsdirect.net

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment Care Compare group NPD
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1821643313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307894",
            "telephone_number": "207-621-7550",
            "fax_number": "207-621-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ENTERPRISE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307894",
            "telephone_number": "207-621-7550",
            "fax_number": "207-621-7551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 North St",
            "address_purpose": "LOCATION",
            "city": "Waterville",
            "state": "ME",
            "postal_code": "049014974",
            "country_code": "US",
            "telephone_number": "207-872-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "ALICIA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "BLANK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Augusta, ME
• Providers in Augusta, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.

Verify at the official NPI Registry.