Individual provider Active NPI

Sonya M Miller, PAC

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1497064539
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1704 Issued in ME
Practice address
1012 Union St
Bangor, ME 04401-3060
Phone
(207) 404-8100
Fax
(207) 947-0435
NPI assigned
Oct 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1704 ME Primary

Addresses

Primary practice location

1012 Union St
Bangor, ME 04401-3060

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200

Other names 1

  • Sonya M Burrell Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171010003777 ME Practitioner - Physician Assistant 7416145487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

1012 Union St
Bangor, ME 04401-3058

992 Union St
Bangor, ME 04401-3057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Apr 1, 2018 Accepting new patients
Penobscot Community Health Center CurrentSince Apr 1, 2018 Accepting new patients
Galion Emergency Physicians Inc Past Accepting new patients

Locations

1012 Union St
Bangor, ME 04401
Phone (207) 404-8200

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

304 Garland St
Bangor, ME 04401
Phone (207) 941-6230

143 5th St
Bangor, ME 04401
Phone (207) 941-6220

885 Broadway
Bangor, ME 04401
Phone (207) 992-5500

92 Pendleton St
Brewer, ME 04412
Phone (207) 404-5700

735 Wilson St
Brewer, ME 04412
Phone (207) 989-1567

79 Parkway S
Brewer, ME 04412
Phone (207) 989-4140

242 Brunswick St
Old Town, ME 04468
Phone (207) 827-6128

203 Stillwater Ave
Old Town, ME 04468
Phone (207) 404-8000

156 Oak St
Old Town, ME 04468
Phone (207) 217-1061

576 Stillwater Ave
Old Town, ME 04468
Phone (207) 404-8000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1497064539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-404-8100",
            "fax_number": "207-947-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SONYA",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONYA",
            "last_name": "BURRELL",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.