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Meredith Paige Kenneally

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

818 Congress St, Portland, ME 04102-3112

PECOS Enrollment

This provider is enrolled in PECOS as MEREDITH KENNEALLY.

Based on the most recent information from CMS, provider Meredith Paige Kenneally 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
1518701010
Provider Type
Individual
Full Name
Kenneally, Meredith Paige
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
6/20/2024
Last Updated
7/30/2024

Contact Information

Practice Location

818 Congress St, Portland, ME 04102-3112

(207) 773-8161

Unlisted Fax

Mailing Location

818 Congress St, Portland, ME 04102-3112

(518) 860-3562

Unlisted Fax

Provider Taxonomies

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

Meredith Paige Kenneally

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Caron, Lydia

Mckeown, Anna

Manley, Bruce G

Palmer, Ashley

Wagman, Diana H

Hanson, Camille Lillian

Palmer, Wil Daniel

Alley, Ian

Niland, Lori A

Hoff, James Robert