Individual provider Active NPI

Anu K. Makynen, PH.D.

  • Clinical Psychologist
  • Portland, ME
National Provider Identifier
1407068943
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS 892 Issued in ME
Practice address
22 Free St
Portland, ME 04101-3960
Phone
(207) 671-4113
NPI assigned
May 4, 2007
Last updated
Dec 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS 892 ME Primary

Addresses

Primary practice location

22 Free St
Portland, ME 04101-3960

Mailing address

12 Rudman Rd
Portland, ME 04102-2220
Phone (207) 671-4113

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070608000271 ME Practitioner - Clinical Psychologist 4688772098

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Rudman Rd
Portland, ME 04102-2220

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS 892MEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Apr 11, 2007 Accepting new patients
Mainehealth CurrentSince Apr 11, 2007 Accepting new patients
Mainehealth Current Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1407068943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RUDMAN RD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022220",
            "telephone_number": "207-671-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FREE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013960",
            "telephone_number": "207-671-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKYNEN",
        "first_name": "ANU",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS 892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.