NPIMap

Individual provider Active NPI

Elizabeth Ann Pavao, FNP, RNFA

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1932202082
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP81333 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-2934
Fax
(207) 662-6389
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN45048 ME
Acute Care Nurse Practitioner 363LA2100X 11680 CT
Family Nurse Practitioner 363LF0000X CNP81333 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2934

Other practice location 1

365 Montauk Ave
New London, CT 06320-4769
Phone (860) 442-0711

Other identifiers 2

IdentifierTypeStateIssuer
30343076MedicaidNH
283620099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040406000621 ME Practitioner - Nurse Practitioner 3678566684 Reassigns benefits to 2 organizations
I20230721000852 CT Practitioner - Nurse Practitioner 3678566684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

84 Campus Dr
Scarborough, ME 04074-7133
Phone (207) 396-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN45048MEMDRegistered Nurse First Assistant
11680CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jul 3, 2023 Accepting new patients
Maine Medical Partners CurrentSince Feb 9, 2004 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Jul 3, 2023 Accepting new patients
Maine Medical Partners Family Current Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 28, 2012 Accepting new patients
Maine Medical Partners Acute Care CurrentSince Feb 9, 2004 Accepting new patients
Mainehealth CurrentSince Oct 28, 2012 Accepting new patients
Mainehealth Past Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

22 Bramhall St
#C
Portland, ME 04102

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: epavao10398@direct.mmc.mainehealth.org

Organizations & group practices 9

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.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1932202082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2934",
            "fax_number": "207-662-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2934",
            "fax_number": "207-662-6389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 Montauk Ave",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "CT",
            "postal_code": "063204769",
            "country_code": "US",
            "telephone_number": "860-442-0711",
            "fax_number": "860-865-2395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVAO",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "FNP,  RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "ME",
            "license": "RN45048",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "11680",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30343076",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283620099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.