NPIMap

Individual provider Active NPI

Robert W Berks, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1124177522
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP81019 Issued in ME
Practice address
100 Campus Ave
Suite 208
Lewiston, ME 04240
Phone
(207) 777-8974
Fax
(207) 777-8946
NPI assigned
Jan 9, 2007
Last updated
Nov 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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 CNP81019 ME Primary

Addresses

Primary practice location

100 Campus Ave
Suite 208
Lewiston, ME 04240

Mailing address

PO Box 95000 LBX 7650
Philadelphia, PA 19195-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rberks1149450@direct.bsmhealth.org St. Mary's Regional Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050727000829 ME Practitioner - Nurse Practitioner 4082642483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
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) 777-4420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP81019MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinical Services, Inc. Current Accepting new patients
Community Clinical Services, Inc. CurrentSince Jun 28, 2001 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2017 Accepting new patients
St. Mary's Regional Medical Center Current Accepting new patients
Community Clinical Services, Inc CurrentSince Jun 28, 2001 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2017 Accepting new patients

Locations

100 Campus Ave
Ste 208
Lewiston, ME 04240
Phone (207) 777-8974

106 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3383

57 Birch St
Ste 102
Lewiston, ME 04240
Phone (207) 753-5400

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

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4420

Interoperability endpoints

  • Direct secure messaging: rberks1149450@direct.bsmhealth.org

Organizations & group practices 6

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 6

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1124177522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LBX 7650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS AVE",
            "address_2": "SUITE 208",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "04240",
            "telephone_number": "207-777-8974",
            "fax_number": "207-777-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKS",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP81019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rberks1149450@direct.bsmhealth.org",
            "affiliation": "Y",
            "affiliationName": "St. Mary's Regional Medical Center",
            "address_1": "93 Campus Ave",
            "city": "Lewiston",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042406030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.