Northern Maine Skin Cancer Center PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NORTHERN MAINE SKIN CANCER CENTER PLLC

Practice address

117 Broadway Ste 3
Bangor, ME 04401-5205

Phone

(207) 802-0853

Fax

(207) 419-2545

NPI assigned

Jun 27, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Faith Whalen, MDNPI 1124256029

Title

Owner

Phone

(415) 802-1310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Faith Miller Whalen, MD

  • Dermatology Physician
  • Bangor, ME
  • NPI 1124256029

  Dermatology, ME

  Medicare reassignment Care Compare group NPD Authorized official
• Samantha Helene Mitchell, FNP-C

  • Dermatology Physician
  • Bangor, ME
  • NPI 1861755209

  Dermatology, ME

  Medicare reassignment Care Compare group NPD
• Sadie Austin, PA-C

  • Surgical Physician Assistant
  • Bangor, ME
  • NPI 1346802170

  ME

  Medicare reassignment Care Compare group
• Alana Rive Silverman, PA-C

  • Surgical Physician Assistant
  • Orono, ME
  • NPI 1609383041

  ME

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1063198554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BROADWAY STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BROADWAY STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015205",
            "telephone_number": "207-802-0853",
            "fax_number": "207-419-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE SKIN CANCER CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-802-1310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Oral & Maxillofacial Surgery Associates P.a.
• Northeast Pain Management, PC
• Northeast Periodoantal Associates
• Northeast Surgery, P.a.
• Northern Light Medical Transport
• Northpoint Home Care
• Casey Marie Northup
• Sheri Murray Norwood, WHNP
• John Nowak, PAC
• Thomas Paul Nowakowski, M.D.

• All providers in Bangor, ME
• Dermatology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.