NPIMap

Individual provider Active NPI

Beverly J Wood, PA-C

  • Physician Assistant
  • Biddeford, ME
National Provider Identifier
1922071349
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1080 Issued in ME
Practice address
61 Barra Road
Biddeford, ME 04005
Phone
(207) 283-1441
Fax
(207) 523-1136
NPI assigned
Feb 8, 2006
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 PA1080 ME Primary

Addresses

Primary practice location

61 Barra Road
Biddeford, ME 04005

Mailing address

PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888

Other identifiers 1

IdentifierTypeStateIssuer
432490199MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address beverly.wood.1@5857.direct.athenahealth.com

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
I20070307000176 ME Practitioner - Physician Assistant 3173531241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

155 Rover River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

175 Fore River Pkwy
Portland, ME 04102-2779
Phone (207) 879-3000

225 Gorham Rd
Suite 303
South Portland, ME 04106-2462
Phone (207) 535-1880

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Physician Assistant CurrentSince Jan 1, 2012 Accepting new patients
Mercy Hospital CurrentSince Jan 29, 2023 Accepting new patients
Mercy Hospital CurrentSince Jan 29, 2023 Accepting new patients

Locations

61 Barra Rd
Biddeford, ME 04005
Phone (207) 283-1441

68 Graham St
Biddeford, ME 04005
Phone (207) 283-1441

74 Baribeau Dr
Brunswick, ME 04011
Phone (207) 798-4050

174 S Freeport Rd
Freeport, ME 04032
Phone (207) 865-1819

510 Main St
Gorham, ME 04038
Phone (207) 216-2118

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

225 Gorham Rd
Ste 303
South Portland, ME 04106
Phone (207) 535-1880

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1922071349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888",
            "fax_number": "207-828-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BARRA ROAD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "04005",
            "telephone_number": "207-283-1441",
            "fax_number": "207-523-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "BEVERLY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432490199",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beverly.wood.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "61 Barra Road",
            "city": "Biddeford",
            "state": "ME",
            "country_code": "US",
            "postal_code": "04005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

Verify at the official NPI Registry.