Individual provider Active NPI

Audrey Patin, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, ME
National Provider Identifier
1063296416
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP231288 Issued in ME
Practice address
180 Park Ave Ste 1
Portland, ME 04102-2927
Phone
(207) 874-2141
Fax
(207) 874-2164
NPI assigned
Aug 24, 2023
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP231288 ME Primary

Addresses

Primary practice location

180 Park Ave Ste 1
Portland, ME 04102-2927

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002003515 ME Practitioner - Nurse Practitioner 9537513098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

93 Campus Ave
Lewiston, ME 04240-6030
Phone (207) 777-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP231288MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Regional Medical Center CurrentSince Oct 28, 2024 Accepting new patients
St. Mary's Regional Medical Center Current Accepting new patients
St. Mary's Regional Medical Center CurrentSince Oct 28, 2024 Accepting new patients

Locations

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

Interoperability endpoints

  • Direct secure messaging: apatin1290972@direct.bsmhealth.org
  • Direct secure messaging: audrey.patin.p1@direct.portlandchc.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1063296416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022927",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIN",
        "first_name": "AUDREY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP231288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.