Look up the most recent NPI and PECOS records

Elizabeth Whitney

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Elizabeth Whitney 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
1376612671
Provider Type
Individual
Full Name
Whitney, Elizabeth
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/8/2006
Last Updated
4/1/2019

Contact Information

Practice Location

1600b Congress St, Portland, ME 04102

(207) 774-5222

Unlisted Fax

Mailing Location

1600b Congress St, Portland, ME 04102-2124

(207) 774-5222

(207) 761-4433

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA-897 Maine
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA897 Maine

Provider Identifiers

ID	Description	Issuer
ID 432093899	Description Medicaid	Issuer Unlisted Maine

Elizabeth Whitney

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Sousa, Sydney Marie

Erickson, Cheri

Mccrossin, Megan A

O'Day, Erin Rose

Merrill, Tina G

Joldersma, Logan

Palmer, Wil Daniel

Bohrmann, Erich J

Macleod, Courtney C.

Troubh, Bonnie Jill