Individual provider Active NPI

Suzette Elizabeth Cyr, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1275972689
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP131012 Issued in ME
Practice address
71 U.S. Route 1
Suite a
Scarborough, ME 04074
Phone
(207) 885-8400
Fax
(207) 885-8499
NPI assigned
Jun 19, 2013
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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 CNP131012 ME Primary

Addresses

Primary practice location

71 U.S. Route 1
Suite a
Scarborough, ME 04074

Mailing address

71 US Route 1
Suite a
Scarborough, ME 04074-7173
Phone (207) 885-8400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150130000295 ME Practitioner - Nurse Practitioner 2668796285 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

736 Old Lewiston Rd
Winthrop, ME 04364-4121
Phone (207) 377-8122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Women's Healthcare CurrentSince Dec 1, 2014 Accepting new patients
Kennebec Valley Mental Health Center CurrentSince Oct 15, 2018 Accepting new patients

Locations

11 Caldwell Rd
Augusta, ME 04330
Phone (207) 623-7710

115 Mt Blue Cir
Farmington, ME 04938
Phone (207) 778-9664

71 US Route 1
Ste A
Scarborough, ME 04074
Phone (207) 885-8400

5 Commerce Dr
Skowhegan, ME 04976
Phone (207) 474-8311

67 Eustis Pkwy
Waterville, ME 04901
Phone (207) 660-4549

736 Old Lewiston Rd
Winthrop, ME 04364
Phone 2073778122 ext. 1407

Organizations & group practices 2

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 2

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1275972689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1",
            "address_2": "SUITE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747173",
            "telephone_number": "207-885-8400",
            "fax_number": "207-885-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 U.S. ROUTE 1",
            "address_2": "SUITE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-885-8400",
            "fax_number": "207-885-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYR",
        "first_name": "SUZETTE",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP131012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.