NPIMap

Organization Active NPI

United Cerebral Palsy of Northeastern Maine

  • Community/Behavioral Health Agency
  • Bangor, ME
National Provider Identifier
1265634893
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CC3374 Issued in ME
Legal business name
UNITED CEREBRAL PALSY OF NORTHEASTERN MAINE
Practice address
700 Mount Hope Ave
Suite 320
Bangor, ME 04401-5680
Phone
(207) 941-2952
Fax
(207) 941-2955
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Authorized official

Name
Candice M Madore
Title
Billing Specialist
Phone
(207) 992-0602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CC3374 ME Primary

Addresses

Primary practice location

700 Mount Hope Ave
Suite 320
Bangor, ME 04401-5680

Mailing address

700 Mount Hope Ave
Suite 320
Bangor, ME 04401-5680
Phone (207) 941-2952

Other identifiers 1

IdentifierTypeStateIssuer
167950200MedicaidME

Other names 1

  • UCP of Maine Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121206000540 ME Part B Supplier - Clinic/Group Practice 6507018058 Receives reassigned benefits from 4 practitioners
4 other NPIs on this enrollment
Practice locations: Bangor, ME

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ucp of Maine18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1265634893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 320",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015680",
            "telephone_number": "207-941-2952",
            "fax_number": "207-941-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE",
            "address_2": "SUITE 320",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015680",
            "telephone_number": "207-941-2952",
            "fax_number": "207-941-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CEREBRAL PALSY OF NORTHEASTERN MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "MADORE",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "207-992-0602"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "CC3374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167950200",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCP of Maine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 29, 2012; 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.