SEAN MICHAEL ETHERIDGE PA-C
NPI 1215547716
Physician Assistant in Scarborough, ME

Q: What is Sean Etheridge's NPI number?

The NPI number for Sean Etheridge is 1215547716. It was assigned to this individual provider in the NPPES registry on August 9, 2020.

Q: What is Sean Etheridge's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Etheridge was last updated on July 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 09, 2020PECOS EnrolledAccepts Medicare Assignment

92 CAMPUS DR STE C, SCARBOROUGH, ME 04074(207) 797-5753 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2024, Aug 9, 2020 (2 updates tracked since 2020).

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About Sean Michael Etheridge Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN MICHAEL ETHERIDGE PA-C (NPI 1215547716) is an individual physician assistant in Scarborough, Maine, licensed in Maine (PA2612) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1215547716

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSEAN MICHAEL ETHERIDGECredential: PA-C

Location Address92 CAMPUS DR STE CScarborough, ME 04074-7229

Mailing Address38 Academy CirOakland, NJ 07436-2625 · (201) 783-5471

Phone(207) 797-5753

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 9, 2020

Last NPPES UpdateJuly 9, 20242 updates tracked since enumeration

NPPES CertifiedJuly 9, 2024

✔ NPI 1215547716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in ME · PA2612

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

92 CAMPUS DR STE C, Scarborough, ME 04074

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sean Michael Etheridge Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335516491

PECOS Enrollment IDI20240803000348

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

48 services22 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Maine Medical Center

Acute Care Hospitals · Portland, ME

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200009

Location22 Bramhall StPortland, ME 04102 · Cumberland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.72 typical visit price

range $56.28 – $169.96

Typical copayment $21.68 (range $14.07 – $42.49)

Most-billed visit code 99203

Established Patient

$70.13 typical visit price

range $18.22 – $138.92

Typical copayment $17.53 (range $4.55 – $34.73)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALIIA IANTSEVYCH FNP

Nurse Practitioner (Family)