Look up the most recent NPI and PECOS records

Cody Bothel

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Cody Bothel 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
1952892978
Provider Type
Individual
Full Name
Bothel, Cody
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
5/24/2018
Last Updated
9/21/2018

Contact Information

Practice Location

33 Sewall St, Portland, ME 04102-2603

(207) 272-2734

Unlisted Fax

Mailing Location

324 Gannett Dr Ste 200, South Portland, ME 04106-3266

(207) 482-7800

(207) 482-7898

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA1793 Maine

Cody Bothel

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Joldersma, Logan

Jones, Rhianna

Kenney, Julianna Cole

Neubauer, David L

Manley, Bruce G

Lyon, Devin Judith

Patrick, Amy M

Lebourdais, Laura Ann

Landry, Addison

Kaletina, Anna