Erin R Van Wagenen, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD20134 Issued in ME

Practice address

12 High St Ste 302
Lewiston, ME 04240-7690

Phone

(207) 795-5730

Fax

(207) 795-5749

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

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.

• Bridgton Hospital

  • Critical Access Hospital
  • Bridgton, ME
  • NPI 1154370153
  Medicare reassignment NPD
• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  Medicare reassignment NPD
• Bridgton Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Bridgton, ME
  • NPI 1477691467
  NPD
• Central Maine Medical Center

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1033874458
  NPD

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1124314513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HIGH ST STE 302",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407690",
            "telephone_number": "207-795-5730",
            "fax_number": "207-795-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HIGH ST STE 302",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407690",
            "telephone_number": "207-795-5730",
            "fax_number": "207-795-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WAGENEN",
        "first_name": "ERIN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "MD20134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Vachon, DPT
• Laura Nancy Vaillancourt, OTR/L
• Maria Ann Valente, LMSW-CC
• Geri Valentine
• Justin Daniel Valiquet, DO
• Kari Vanderhorn, LMT
• Emilie Varle
• Sarah Elizabeth Varney, CRNA
• Vein and Wound Care PA
• Cecile J Velilla, LCSW

• Pediatrics Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.