NPIMap

Individual provider Active NPI

Precious Shenandoah Dean, PA

  • Physician Assistant
  • Brunswick, ME
National Provider Identifier
1972924561
Registry record updated Jan 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
331 Maine St
Suite 23
Brunswick, ME 04011-3358
Phone
(207) 729-0134
Fax
(207) 729-6626
NPI assigned
Dec 27, 2013
Last updated
Jan 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Physician Assistant 363A00000X 017412 NY

Addresses

Primary practice location

331 Maine St
Suite 23
Brunswick, ME 04011-3358

Mailing address

331 Maine St
Suite 23
Brunswick, ME 04011-3358
Phone (207) 729-0134

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
I20140821000233 ME Practitioner - Physician Assistant 2668690348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
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

Hospital & facility affiliations

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017412NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Feb 15, 2016 Accepting new patients
Midcoast Hospital CurrentSince Jan 26, 2015 Accepting new patients
Maine Medical Partners CurrentSince Feb 15, 2016 Accepting new patients
Mainehealth CurrentSince Feb 15, 2016 Accepting new patients
Maine Medical Partners Physician Assistant CurrentSince Feb 15, 2016 Accepting new patients
Parkview Medical Associates, PA Past Accepting new patients
Boston University General Surgical Associates, Inc.-QMC Past Accepting new patients

Locations

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

331 Maine St
Ste 23
Brunswick, ME 04011
Phone (207) 729-0134

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

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

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

Interoperability endpoints

  • Direct secure messaging: pdean132569@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452902400000",
    "number": "1972924561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 MAINE ST",
            "address_2": "SUITE 23",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113358",
            "telephone_number": "207-729-0134",
            "fax_number": "207-729-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 MAINE ST",
            "address_2": "SUITE 23",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113358",
            "telephone_number": "207-729-0134",
            "fax_number": "207-729-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "PRECIOUS",
        "middle_name": "SHENANDOAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2016-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.