Renew Wound Care of Maine PLLC
Organization Active NPI Internal Medicine Physician · North Berwick, ME
NPI 1922889104 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1922889104
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- RENEW WOUND CARE OF MAINE PLLC
- Practice address
- 47 Elm St
North Berwick, ME 03906-6792 - Phone
- (929) 491-7700
- NPI assigned
- Oct 12, 2023
- Organization subpart
- No
Authorized official
- Name
- Joseph Wiesenfeld
- Title
- Administrator
- Phone
- (718) 408-8860
Practitioners 4
-
Melissa Vann-Combs, FNP
-
Julie P Quinn, PA-C
-
Rekha Bhandari, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250116002497 | ME | Part B Supplier - Clinic/Group Practice | 4284162322 |
Receives reassigned benefits from 3 practitioners Practice locations: North Berwick, ME |
National Provider Directory
Locations
74 Parkway S
Brewer, ME 04412
Phone (207) 989-7300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse |
163WW0000X | |||
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
47 Elm St
North Berwick, ME 03906-6792
Mailing address
1481 McDonald Ave
Brooklyn, NY 11230-4667
Other providers in North Berwick, ME
- Occupational Health Centers of the Southwest P.a.
- Joseph Lawrence Pelletier
- Christine Petrillo
- Pinnacle Group of Hudson Valley III LLC
- Recovery Maine, Inc.
- Residential and Community Support Services
- Rise Counseling Services, LLC
- Mark Andrew Rouillard
- Erin E Roy-Pelletier
- Rsu/Sad#60
All providers in North Berwick, ME · Internal Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.