Mary Desalle, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP081312 Issued in ME

Practice address

655 Main St
Saco, ME 04072-1543

Phone

(207) 602-3571

Fax

(207) 602-3573

NPI assigned

Dec 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Androscoggin Home Health Services IncGroup PAC ID 2668467614, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Androscoggin Home Health Services, Inc

  • Internal Medicine Physician
  • Lewiston, ME
  • NPI 1013957687
  Medicare reassignment Care Compare group NPD
• Androscoggin Home Health Services, Inc.

  • Clinical Social Worker
  • Lewiston, ME
  • NPI 1346847415
  NPD
• Androscoggin Home Health Services, Inc.

  • Developmental Therapist
  • Lewiston, ME
  • NPI 1962646844
  NPD
• Community Clinical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1629851761
  NPD (past)
• Mercy Hospital

  • Rural Health Clinic/Center
  • Windham, ME
  • NPI 1396496378
  NPD (past)
• University of New England

  • Occupational Therapist
  • Biddeford, ME
  • NPI 1467439778
  NPD (past)
• University of New England

  • Family Medicine Physician
  • Biddeford, ME
  • NPI 1699752055

  Gerontology

  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1427034396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053020284",
            "telephone_number": "207-784-2554",
            "fax_number": "207-777-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MAIN ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721543",
            "telephone_number": "207-602-3571",
            "fax_number": "207-602-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESALLE",
        "first_name": "MARY",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "R026628",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "AP081312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "100072",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "304310001",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427034396",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2735452",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "MN5036",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500017332",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debbie Papps LCSW LLC
• Deborah a Dana LCSW LLC
• Yvonne L. Decory, MD
• Emma Rae Denbow, RDN, LDN
• Sara Jeanne Denning-Bolle, DO
• Meagan Desjardins, LMSW-CC
• Danielle Rachel Desplaines, MS, LCPC, CMHS
• Dolores Despres, MSW
• Philip R. Deveau, LCSW
• Lisa A Digiovanni, LCSW

• Gerontology Nurse Practitioner in Saco, ME
• Providers in Saco, ME by specialty
• Gerontology Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.