Individual provider Active NPI

Alynna Mariz Samala Perez, MD

  • Student in an Organized Health Care Education/Training Program
  • Bangor, ME
National Provider Identifier
1417636390
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
895 Union St Ste 12
Bangor, ME 04401-3054
Phone
(207) 973-7979
Fax
(207) 947-9579
NPI assigned
Jul 17, 2023
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Family Medicine Physician 207Q00000X 38128 NH

Addresses

Primary practice location

895 Union St Ste 12
Bangor, ME 04401-3054

Mailing address

250 Pleasant St
Concord, NH 03301-2598
Phone (603) 227-7000

Other practice location 1

15 Aiken Ave
Franklin, NH 03235-1259
Phone (603) 934-4259

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aperez@crhc.cernerdirect.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823000935 ME Order and Referring Only - Family PracticePractitioner - Family Practice 9537522685

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38128NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jul 23, 2023 Accepting new patients
Eastern Maine Medical Center PastSince Jul 23, 2023 Accepting new patients

Locations

895 Union St
Ste 12
Bangor, ME 04401
Phone (207) 973-7973

43 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1417636390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012598",
            "telephone_number": "603-227-7000",
            "fax_number": "603-230-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 UNION ST STE 12",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013054",
            "telephone_number": "207-973-7979",
            "fax_number": "207-947-9579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Aiken Ave",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NH",
            "postal_code": "032351259",
            "country_code": "US",
            "telephone_number": "603-934-4259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "ALYNNA MARIZ",
        "middle_name": "SAMALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "38128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aperez@crhc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Concord Hospital direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "15 Aiken Ave",
            "city": "Franklin",
            "state": "NH",
            "country_code": "US",
            "postal_code": "032351259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.