Peter M Mirkin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

014555 Issued in ME

Practice address

477 Congress St
5TH Floor
Portland, ME 04101-3427

Phone

(207) 329-1553

NPI assigned

Jul 27, 2009

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mainehealth

  dba MaineHealth Pharmacy Maine Medical Center Biddeford

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  Medicare reassignment NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• Community Concepts, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Rumford, ME
  • NPI 1275774739
  NPD (past)

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1578794467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PHINNEY ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382061",
            "telephone_number": "207-329-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 CONGRESS ST",
            "address_2": "5TH FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013427",
            "telephone_number": "207-329-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRKIN",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "014555",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "020367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE STATE LICENSE",
            "identifier": "014555",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT STATE LICENSE",
            "identifier": "020367",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minh Lam
• Joseph Minichiello, MD
• Anna Nicole Mininni, AGACNP
• Jennifer Minthorn
• Courtney Leigh Minzy, PA-C
• Brittany Misercola, M.D.
• Zara Misler, BCBA
• Bayan Missaghi, MD
• Andrew Mitchell
• Charles Hopkins Mitchell, MD

• Psychiatry Physician in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.