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Elyssa Denault

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Elyssa Denault is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1053271585
Provider Type
Individual
Full Name
Denault, Elyssa
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/17/2025
Last Updated
11/17/2025

Contact Information

Practice Location

22 Bramhall St, Portland, ME 04102-3134

(207) 662-0111

Unlisted Fax

Mailing Location

8 Tigger Ln, South Hadley, MA 01075-3315

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Elyssa Denault

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Klotz, Robert

Landry, Addison

Harvey, Amy Christine

Beadlecomb, Kaleigh Elizabeth

Lavoie, Sarah A

Beauregard, Meredith

Halterman, Jon M

Hazard, Samuel Emerson

White, Alan G

Mccrossin, Megan A