Individual provider Active NPI

Marilyn Kathryn Mandich, RRT

  • Critical Care Registered Respiratory Therapist
  • Augusta, ME
National Provider Identifier
1497776371
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X
License
TH880 Issued in ME
Practice address
1 VA Ctr
Augusta, ME 04330-6719
Phone
(207) 623-8411
Fax
(207) 626-4753
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X TH880 ME
Critical Care Registered Respiratory Therapist 2279C0205X TH880 ME Primary

Addresses

Primary practice location

1 VA Ctr
Augusta, ME 04330-6719

Mailing address

732 River Rd
Dresden, ME 04342-4065
Phone (207) 623-8411

Other names 1

  • Marilyn Mandich Poliakoff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TH880MEMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1497776371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 RIVER RD",
            "city": "DRESDEN",
            "state": "ME",
            "postal_code": "043424065",
            "telephone_number": "207-623-8411",
            "fax_number": "207-626-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VA CTR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306719",
            "telephone_number": "207-623-8411",
            "fax_number": "207-626-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDICH",
        "first_name": "MARILYN",
        "middle_name": "KATHRYN",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "ME",
            "license": "TH880",
            "primary": false
        },
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "ME",
            "license": "TH880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "POLIAKOFF",
            "middle_name": "MANDICH",
            "credential": "RRT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.