Individual provider Active NPI

Miriam Ibhade Uduebor, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Augusta, ME
National Provider Identifier
1477120590
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD24835 Issued in ME
Practice address
6 E Chestnut St
Augusta, ME 04330-5758
Phone
(207) 626-7400
Fax
(207) 626-7401
NPI assigned
Jun 8, 2021
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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 EC211071 ME
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD24835 ME Primary

Addresses

Primary practice location

6 E Chestnut St
Augusta, ME 04330-5758

Mailing address

6 E Chestnut St
Augusta, ME 04330-5758
Phone (207) 626-7400

Other practice location 1

15 E Chestnut St
Augusta, ME 04330-5736
Phone (207) 626-1561

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
I20250826000728 ME Practitioner - Geriatric Medicine 1052711090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

114 Bath Rd
Brunswick, ME 04011-2606
Phone (207) 798-4400

6 E Chestnut St
Augusta, ME 04330-5758
Phone (207) 621-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24835MEMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Geriatric Medicine CurrentSince Dec 29, 2025 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 21, 2025 Accepting new patients
Mainegeneral Medical Center CurrentSince Aug 21, 2025 Accepting new patients

Locations

15 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1561

6 E Chestnut St
Augusta, ME 04330
Phone (207) 626-1236

114 Bath Rd
Brunswick, ME 04011
Phone (207) 798-4400

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
  • Direct secure messaging: miriam.uduebor.1@5857.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1477120590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305758",
            "telephone_number": "207-626-7400",
            "fax_number": "207-626-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305758",
            "telephone_number": "207-626-7400",
            "fax_number": "207-626-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043305736",
            "country_code": "US",
            "telephone_number": "207-626-1561",
            "fax_number": "207-626-1849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UDUEBOR",
        "first_name": "MIRIAM",
        "middle_name": "IBHADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": "EC211071",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "ME",
            "license": "MD24835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.