NPIMap

Individual provider Active NPI

Angela Diane Bacchiocchi, PA-C

  • Surgical Physician Assistant
  • Bangor, ME
National Provider Identifier
1457607244
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1350 Issued in ME
Practice address
417 State St
Suite 221
Bangor, ME 04401-6630
Phone
(207) 973-9949
NPI assigned
Jul 30, 2012
Last updated
Jul 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA1350 ME Primary

Addresses

Primary practice location

417 State St
Suite 221
Bangor, ME 04401-6630

Mailing address

909 Blackstream Rd
Hermon, ME 04401-0207
Phone (413) 575-6118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000580 ME Practitioner - Physician Assistant 7214188994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 9, 2018 Accepting new patients
Maine Medical Partners CurrentSince Jul 9, 2018 Accepting new patients
Maine Medical Partners CurrentSince Jul 9, 2018 Accepting new patients
Mainehealth CurrentSince Jul 9, 2018 Accepting new patients
Eastern Maine Medical Center CurrentSince Aug 26, 2012 Accepting new patients
Mainehealth Past Accepting new patients

Locations

417 State St
Ste 221
Bangor, ME 04401
Phone (207) 973-9561

489 State St
Bangor, ME 04401
Phone (207) 973-8837

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

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: abacchiocchi226379@direct.mmc.mainehealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1457607244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 BLACKSTREAM RD",
            "city": "HERMON",
            "state": "ME",
            "postal_code": "044010207",
            "telephone_number": "413-575-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "SUITE 221",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-973-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCHIOCCHI",
        "first_name": "ANGELA",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA1350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.