Active NPI
Shannon Janice Ezovski, MD
- Child & Adolescent Psychiatry Physician
- Westbrook, ME
National Provider Identifier
1134624125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD26680
- Practice address
- 123 Andover Rd
Westbrook, ME 04092-3848 - Phone
- (207) 761-2200
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD26680 | ME | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD26680 | ME | Primary |
Addresses
Primary practice location
123 Andover Rd
Westbrook, ME 04092-3848
Mailing address
123 Andover Rd
Westbrook, ME 04092-3848
Phone (207) 761-2200
Other practice location 1
216 Vaughan St
Portland, ME 04102-3204
Phone (076) 622-2221
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Tufts University School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
216 Vaughan St
Portland, ME 04102-3204
Phone (207) 662-2221
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD26680 | ME | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
216 Vaughan St
Portland, ME 04102
Phone (207) 662-2221
123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200
Interoperability endpoints
- swalsh223547@direct.mmc.mainehealth.org
Organizations & group practices 4
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Clinic/Center
- Portland, ME
- NPI 1487346722
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1598798787
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1134624125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 ANDOVER RD",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923848",
"telephone_number": "207-761-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 ANDOVER RD",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923848",
"telephone_number": "207-761-2200"
}
],
"practiceLocations": [
{
"address_1": "216 Vaughan St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041023204",
"country_code": "US",
"telephone_number": "076-622-2221",
"fax_number": "207-810-2367",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EZOVSKI",
"first_name": "SHANNON",
"middle_name": "JANICE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "MD26680",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "ME",
"license": "MD26680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.
- 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.