Individual provider Active NPI

Steven Petrin, FNP

  • Nurse Practitioner
  • Sanford, ME
National Provider Identifier
1609852086
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP81444 Issued in ME
Practice address
25 June St
Sanford, ME 04073-2621
Phone
(207) 490-7860
Fax
(207) 604-7409
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP81444 ME Primary

Addresses

Primary practice location

25 June St
Sanford, ME 04073-2621

Mailing address

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7000

Other identifiers 1

IdentifierTypeStateIssuer
431954499MedicaidME

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
I20050927000206 ME Practitioner - Nurse Practitioner 3779517925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
University of New England Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

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

25A June St
Ste 111
Sanford, ME 04073
Phone (207) 324-5968

25 June St
Sanford, ME 04073
Phone (207) 324-4310

Interoperability endpoints

  • Direct secure messaging: spetrin157028@direct.mmc.mainehealth.org

Organizations & group practices 6

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1609852086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-283-7000",
            "fax_number": "207-282-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JUNE ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732621",
            "telephone_number": "207-490-7860",
            "fax_number": "207-604-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIN",
        "first_name": "STEVEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP81444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431954499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

Verify at the official NPI Registry.