STANLEY O PETTEGROW LCSW
NPI 1487674859
Social Worker - Clinical in Old Town, ME
About Stanley O Pettegrow Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STANLEY O PETTEGROW LCSW (NPI 1487674859) is an individual clinical provider in Old Town, Maine, licensed in Maine (LC11074) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Stanley O Pettegrow Lcsw 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.
Medicare Billing Reassignment
Medicare enrollment records show Stanley Pettegrow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Old Town, ME 04468
- Reassigned Medicare billing, Maine enrollment
- 144 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 04468 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OLD TOWN, ME 04468
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stanley Pettegrow's NPI number?
The NPI number for Stanley Pettegrow is 1487674859. It was assigned to this individual provider in the NPPES registry on July 20, 2006.
Where is Stanley Pettegrow located?
Stanley Pettegrow practices at 242 Brunswick St, Old Town, ME 04468. The listed phone number is (207) 827-6128.
What is Stanley Pettegrow's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Stanley Pettegrow enrolled in Medicare?
Yes. Stanley Pettegrow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Stanley Pettegrow's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stanley Pettegrow reassigns Medicare benefits to Penobscot Community Health Center (Old Town, ME). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stanley Pettegrow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stanley Pettegrow accept?
Health plans from Anthem Blue Cross and Blue Shield list Stanley Pettegrow as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Stanley Pettegrow was last updated on May 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Stanley O Pettegrow, LCSW · NPI 1487674859
Clinical provider in Old Town, Maine. Individual provider, active in the CMS NPPES registry since July 20, 2006.
## Identity
- **NPI:** 1487674859 (Entity type: Individual)
- **Enumerated:** July 20, 2006
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** LC11074 (Maine)
- **Sole proprietor:** No
## Practice location
- **Address:** 242 BRUNSWICK ST, Old Town, ME 04468-1613
- **Phone:** (207) 827-6128
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Penobscot Community Health Center (NPI 1629161559, Old Town, ME), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** May 5, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1487674859) · Data from the CMS NPPES public registry.