Northeast Nephrology PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NORTHEAST NEPHROLOGY PA

Practice address

417 State St
Ste 321
Bangor, ME 04401-6638

Phone

(207) 973-8833

Fax

(207) 973-8836

NPI assigned

Jun 24, 2005

Last updated

May 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen G Comeau, M.D.NPI 1538165402

Title

President

Phone

(207) 973-8833

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Gerard Comeau, M.D.

  • Nephrology Physician
  • Bangor, ME
  • NPI 1538165402
  Medicare reassignment Care Compare group NPD Authorized official
• Hui Liu, M.D.

  • Nephrology Physician
  • Bangor, ME
  • NPI 1487898235
  Medicare reassignment Care Compare group NPD
• Manish Nepal, MD

  • Nephrology Physician
  • Bangor, ME
  • NPI 1982862751
  Medicare reassignment Care Compare group NPD
• Mihail Ion Soare, M.D.

  • Nephrology Physician
  • Bangor, ME
  • NPI 1194906859
  Medicare reassignment Care Compare group NPD
• Amanda Ann Theriault, APRN-CNP

  • Adult Health Nurse Practitioner
  • Bangor, ME
  • NPI 1548997521
  Medicare reassignment Care Compare group NPD
• Michael C McGoldrick, MD

  • Nephrology Physician
  • Bangor, ME
  • NPI 1285749085
  Medicare reassignment Care Compare group
• Ralph B McPherson, LCSW

  • Clinical Social Worker
  • Presque Isle, ME
  • NPI 1033135645
  NPD (past)
• Richard A Patch, MD

  • Nephrology Physician
  • Bangor, ME
  • NPI 1225258213
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1336145200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 321",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016638",
            "telephone_number": "207-973-8833",
            "fax_number": "207-973-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 321",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016638",
            "telephone_number": "207-973-8833",
            "fax_number": "207-973-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST NEPHROLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "COMEAU",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-973-8833",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132020000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seann Norris, LMSW-CC
• Northeast Cardiology Associates
• Northeast Chiropractic Center
• Northeast Chiropractic Center PA
• Northeast Eyecare, Inc. (Eye Center Northeast)
• Northeast Neurosurgery, P.a.
• Northeast Occupational Exchange, Inc
• Northeast Oral & Maxillofacial Surgery Associates P.a.
• Northeast Pain Management, PC
• Northeast Periodoantal Associates

• Nephrology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Nephrology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.