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Sarah Black Wiesendanger Patton

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1601 Congress St, Portland, ME 04102-2102

PECOS Enrollment

This provider is enrolled in PECOS as SARAH PATTON.

Based on the most recent information from CMS, provider Sarah Black Wiesendanger Patton 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
1952391435
Provider Type
Individual
Full Name
Patton, Sarah Black Wiesendanger
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
10/25/2005
Last Updated
4/3/2023

Contact Information

Practice Location

1601 Congress St, Portland, ME 04102-2102

(207) 661-0100

(207) 661-0199

Mailing Location

23 Rosemary Ln, Freeport, ME 04032-6034

(206) 450-1361

(206) 346-6022

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA2186 Maine
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA10005002 Washington

Provider Identifiers

ID	Description	Issuer
ID 1551PA	Description Other	Issuer BLUE CROSS BLUE SHEILD Washington

Sarah Black Wiesendanger Patton

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Smith, Diana

Berry, Elizabeth C

Kelly, Amanda Rose

Hanley, Sarah Victoria

Bohrmann, Erich J

Butterfield, Blue B

Foley, Sheila Marie

Mccrossin, Megan A

Palmer, Wil Daniel

Amdahl, Lola Louise