NPIMap

Individual provider Active NPI

Fredericka Sadovnikoff

  • Physician Assistant
  • Porter, ME
National Provider Identifier
1891458295
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2622 Issued in ME
Practice address
70 Main St
Porter, ME 04068-3527
Phone
(207) 625-8126
Fax
(207) 625-7820
NPI assigned
Oct 21, 2021
Last updated
Feb 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2622 ME Primary

Addresses

Primary practice location

70 Main St
Porter, ME 04068-3527

Mailing address

70 Main St
Porter, ME 04068-3527
Phone (207) 625-8126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219001869 ME Practitioner - Physician Assistant 7113361056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacopee Valley Health CenterGroup PAC ID 5597664854, 19 clinicians

Practice addresses (Care Compare)

70 Main St
Porter, ME 04068-3527
Phone (207) 625-8126

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2622MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sacopee Valley Health Center CurrentSince Apr 1, 2024 Accepting new patients

Locations

70 Main St
Porter, ME 04068
Phone (207) 625-8126

Interoperability endpoints

  • Direct secure messaging: fredericka.sadovnikoff.p1@direct.svhc.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 41

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1891458295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "PORTER",
            "state": "ME",
            "postal_code": "040683527",
            "telephone_number": "207-625-8126",
            "fax_number": "207-625-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "PORTER",
            "state": "ME",
            "postal_code": "040683527",
            "telephone_number": "207-625-8126",
            "fax_number": "207-625-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADOVNIKOFF",
        "first_name": "FREDERICKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porter, ME

Sources for this page

Verify at the official NPI Registry.