Kathryn Marie Mordino, ANP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP231559 Issued in ME

Practice address

21 E Summer St
Bangor, ME 04401-5513

Phone

(617) 435-7601

NPI assigned

Jan 3, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Kathryn Marie Soucy Former name

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Bangor, ME, CCN 207045
• Bristol Hospice - Bangor LLC Hospice, Bangor, ME, CCN 201526
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmordino191035@direct.ochin.org
• Direct secure messaging: kathryn.mordino.1@30940.direct.athenahealth.com

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.

• Aging Grace House Calls, Professional Corporation

  • Primary Care Clinic/Center
  • Bangor, ME
  • NPI 1336919091

  ME

  Medicare reassignment NPD Authorized official
• Comprehensive Rehab Consultants PLLC

  • Physical Medicine & Rehabilitation Physician
  • Middle River, MD
  • NPI 1710529771

  ME, Nurse Practitioner

  Medicare reassignment NPD

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

• Bristol Hospice - Bangor, LLC

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1336916469

  Hospice

  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Bangor, ME
  • NPI 1982638771
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147

  Hospital

  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1497092969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E SUMMER ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015513",
            "telephone_number": "617-435-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E SUMMER ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015513",
            "telephone_number": "617-435-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDINO",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN283154",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN283154",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN283154",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP231559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SOUCY",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Renee Marie Moran, P.T.
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• Michael Moreau, PA
• Sarah Moreau, CFNP
• Olive Morelli
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• All providers in Bangor, ME
• Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.