Active NPI
Micralyn Denee Wiechman, APRN, FNP-C, ENP-C
- Family Nurse Practitioner
- Sanford, ME
National Provider Identifier
1013562685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP141132
- Practice address
- 25A June St
Sanford, ME 04073-2642 - Phone
- (207) 490-7900
- NPI assigned
- Aug 9, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP141132 | TX | |
| Family Nurse Practitioner | 363LF0000X | CNP211033 | ME | |
| Family Nurse Practitioner | 363LF0000X | AP141132 | TX | Primary |
Addresses
Primary practice location
25A June St
Sanford, ME 04073-2642
Mailing address
25A June St
Sanford, ME 04073-2642
Phone (207) 490-7900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013562685 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
25 A June St
Sanford, ME 04073-2642
655 Main St
Saco, ME 04072-1699
Phone (207) 294-5959
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP141132 | TX | MD | Nurse Practitioner |
| CNP211033 | ME | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Phoebe Physician Group, Inc | Current | Accepting new patients | |
| Phoebe Infectious Disease | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
2336 Dawson Rd
Ste 1600
Albany, GA 31707
Phone (229) 312-8750
2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802
151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
25A June St
Sanford, ME 04073
Phone (207) 324-8311
Interoperability endpoints
- mwiechman383866@direct.mmc.mainehealth.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Pediatrics Physician
- Falmouth, ME
- NPI 1629382601
-
- Clinic/Center
- Albany, GA
- NPI 1114220852
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1013562685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25A JUNE ST",
"city": "SANFORD",
"state": "ME",
"postal_code": "040732642",
"telephone_number": "207-490-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25A JUNE ST",
"city": "SANFORD",
"state": "ME",
"postal_code": "040732642",
"telephone_number": "207-490-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIECHMAN",
"first_name": "MICRALYN",
"middle_name": "DENEE",
"name_prefix": "Ms.",
"credential": "APRN, FNP-C, ENP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-09",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "AP141132",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ME",
"license": "CNP211033",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP141132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013562685",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sanford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.