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Amy M Patrick

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

(207) 662-2381 (207) 661-2000

PECOS Enrollment

This provider is enrolled in PECOS as AMY PATRICK.

Based on the most recent information from CMS, provider Amy M Patrick 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
1730439746
Provider Type
Individual
Full Name
Patrick, Amy M
Title
Ms.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/17/2012
Last Updated
4/25/2017

Contact Information

Practice Location

22 Bramhall St, Portland, ME 04102-3134

(207) 662-2381

(207) 662-6226

Mailing Location

190 Riverside St, Suite 6b, Portland, ME 04103-1073

(207) 661-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA1397 Maine
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA4474 Massachusetts
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA329 Maine

Amy M Patrick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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