Individual provider Active NPI

Nicole Sarah Rockwell Jederlinic, DO

  • Child & Adolescent Psychiatry Physician
  • Rockland, ME
National Provider Identifier
1598185191
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
DO3501 Issued in ME
Practice address
12 Union St
Rockland, ME 04841-2739
Phone
(207) 701-4400
Fax
(207) 701-4487
NPI assigned
Apr 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34.012476 OH
Psychiatry Physician 2084P0800X DO3501 ME
Child & Adolescent Psychiatry Physician 2084P0804X 34.012476 OH
Child & Adolescent Psychiatry Physician 2084P0804X DO3501 ME Primary

Addresses

Primary practice location

12 Union St
Rockland, ME 04841-2739

Mailing address

12 Union St
Rockland, ME 04841-2739
Phone (844) 292-0111

Other practice location 1

4075 Old Western Row Rd
Mason, OH 45040-3104
Phone (513) 536-0254

Other practice location 2

15 Anchor Dr Ste 103
Rockport, ME 04856-3847
Phone (207) 301-5600

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
I20230222002007 ME Practitioner - Psychiatry 0143558585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York College of Osteo Medicine of New York Institute of Technology, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

12 Union St
Rockland, ME 04841-2739
Phone (844) 292-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Mar 27, 2023 Accepting new patients
Mainehealth CurrentSince Mar 27, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

12 Union St
Rockland, ME 04841
Phone (207) 701-4400

15 Anchor Dr
Ste 103
Rockport, ME 04856
Phone (207) 301-5600

Interoperability endpoints

  • Direct secure messaging: njederlinic83449@direct.mmc.mainehealth.org

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.

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1598185191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "844-292-0111",
            "fax_number": "207-701-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-701-4400",
            "fax_number": "207-701-4487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4075 Old Western Row Rd",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "450403104",
            "country_code": "US",
            "telephone_number": "513-536-0254",
            "fax_number": "513-536-0609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Anchor Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "048563847",
            "country_code": "US",
            "telephone_number": "207-301-5600",
            "fax_number": "207-301-5360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEDERLINIC",
        "first_name": "NICOLE",
        "middle_name": "SARAH ROCKWELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.012476",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "DO3501",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "34.012476",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ME",
            "license": "DO3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

Verify at the official NPI Registry.