Active NPI
Diane M. Mazerolle, RN
- Registered Nurse
- Bangor, ME
National Provider Identifier
1386866879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 018634
- Practice address
- 1 Cumberland PL Ste 108
Bangor, ME 04401-5087 - Phone
- (207) 990-9000
- Fax
- (207) 945-8645
- NPI assigned
- May 3, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 018634 | ME | Primary |
Addresses
Primary practice location
1 Cumberland PL Ste 108
Bangor, ME 04401-5087
Mailing address
20 Oak Street
Kenduskeag, ME 04450
Phone (207) 884-6068
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018634 | ME | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gentiva Health Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Home Health Agency
- Hampden, ME
- NPI 1538362314
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386866879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 OAK STREET",
"city": "KENDUSKEAG",
"state": "ME",
"postal_code": "04450",
"telephone_number": "207-884-6068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CUMBERLAND PL STE 108",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015087",
"telephone_number": "207-990-9000",
"fax_number": "207-945-8645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZEROLLE",
"first_name": "DIANE",
"middle_name": "M.",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ME",
"license": "018634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.