Active NPI
Nicole Gallagher Gosselin, PA-S2
- Physician Assistant
- Saco, ME
National Provider Identifier
1841928322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 13 Industrial Park Rd
Saco, ME 04072-1804 - Phone
- (860) 573-3539
- NPI assigned
- Aug 11, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
13 Industrial Park Rd
Saco, ME 04072-1804
Mailing address
716 Stevens Ave
Portland, ME 04103-2656
Phone (860) 573-3539
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13 Industrial Park Rd
Saco, ME 04072-1804
Phone (207) 283-8800
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Physician Assistant | Current | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
13 Industrial Park Rd
Saco, ME 04072
Phone (207) 283-8800
Interoperability endpoints
- ngosselin595535@direct.mmc.mainehealth.org
Organizations & group practices 3
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
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
Hospital & facility affiliations 36
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": "1660176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1841928322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 STEVENS AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032656",
"telephone_number": "860-573-3539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 INDUSTRIAL PARK RD",
"city": "SACO",
"state": "ME",
"postal_code": "040721804",
"telephone_number": "860-573-3539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSSELIN",
"first_name": "NICOLE",
"middle_name": "GALLAGHER",
"credential": "PA-S2",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-11",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.