Acadia Medical Arts Ambulatory Surgical Suite

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

20C0001007 Issued in ME

Legal business name

ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE

Practice address

73 Ridgewood Drive
Bangor, ME 04401

Phone

(207) 990-0928

Fax

(207) 990-3844

NPI assigned

Aug 11, 2006

Last updated

Feb 17, 2022By 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

Melanie Sibley

Title

Administrator

Phone

(207) 262-6974

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Listed as

Acadia Medical Arts Ambulatory Surgical SuiteCCN 20C0001007

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Acadia Medical Arts Anesthesia LLC

  • Specialist
  • Bangor, ME
  • NPI 1124185376

  Member Of

  NPD member
• Acadia Medical Arts Pain Management LLC

  • Pain Medicine (Anesthesiology) Physician
  • Bangor, ME
  • NPI 1063607422

  Member Of

  NPD member

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Acadia Medical Arts Anesthesia LLC

  • Specialist
  • Bangor, ME
  • NPI 1124185376
  NPPES parent name

Practitioners 3

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.

• Garrett R Martin, MD

  • Orthopaedic Surgery Physician
  • Bangor, ME
  • NPI 1669476438
  NPD
• Stephen M Walsh, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Bangor, ME
  • NPI 1386690501
  NPD
• Kenneth Russell Morse, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Bangor, ME
  • NPI 1609885219
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1407867583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 RIDGEWOOD DRIVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-433-7039",
            "fax_number": "207-990-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 RIDGEWOOD DRIVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-990-0928",
            "fax_number": "207-990-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIA MEDICAL ARTS AMBULATORY SURGICAL SUITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "SIBLEY",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-262-6974"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ME",
            "license": "20C0001007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5444660",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "902425",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121350000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "490001551",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "100342300",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "201007001007",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Acadia Foot & Ankle PA (Acadia Foot & Ankle)
• Acadia Foot & Ankle, PA
• Acadia Healthcare, Inc
• Acadia Hospital
• Acadia Hospital Corp
• Acadia Medical Arts Anesthesia LLC
• Acadia Medical Arts Pain Management LLC
• Acadia OB-GYN Associates, P.a.
• Acadia Residential Care.LLC
• Gloria Ngozi Achufuna-Okeke, PHARMACIST

• Ambulatory Surgical Clinic/Center in Bangor, ME
• Providers in Bangor, ME by specialty
• Ambulatory Surgical Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.