NPIMap

Organization Active NPI

Acadia Medical Arts Anesthesia LLC

  • Specialist
  • Bangor, ME
National Provider Identifier
1124185376
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ACADIA MEDICAL ARTS ANESTHESIA LLC
Practice address
73 Ridgewood Dr
Bangor, ME 04401-2652
Phone
(207) 433-7039
Fax
(207) 945-4354
NPI assigned
Jan 3, 2007
Organization subpart
Yes
Parent organization
ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Ms. Paulette A Blue, R.N.
Title
Administrator
Phone
(207) 990-0928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

73 Ridgewood Dr
Bangor, ME 04401-2652

Mailing address

73 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 433-7039

Other identifiers 5

IdentifierTypeStateIssuer
DB9624OtherMERR MEDICARE PIN
1252492OtherMECIGNA
310030400OtherMEUS DEPT OF LABOR
7515715OtherMEAETNA
163600000MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000859 ME Part B Supplier - Clinic/Group Practice 6002802345 Receives reassigned benefits from 15 practitioners
Practice locations: Bangor, ME

National Provider Directory

National Provider Directory
Part of
Acadia Medical Arts Ambulatory Surgical Suite

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

404 State St
Ste 200
Bangor, ME 04401
Phone (207) 990-0928

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1124185376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-433-7039",
            "fax_number": "207-945-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-433-7039",
            "fax_number": "207-945-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIA MEDICAL ARTS ANESTHESIA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE",
        "enumeration_date": "2007-01-03",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "BLUE",
        "authorized_official_first_name": "PAULETTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-990-0928",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "DB9624",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1252492",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "310030400",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7515715",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163600000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.