NPIMap

Individual provider Active NPI

Bonnie L. Rademacher-Flis, CNP

  • Adult Health Nurse Practitioner
  • Boothbay Harbor, ME
National Provider Identifier
1619953312
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP121078 Issued in ME
Practice address
6 St. Andrews Lane
Boothbay Harbor, ME 04538-1847
Phone
(207) 633-1600
Fax
(207) 633-1615
NPI assigned
Dec 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 001556 CT
Adult Health Nurse Practitioner 363LA2200X CNP121078 ME Primary

Addresses

Primary practice location

6 St. Andrews Lane
Boothbay Harbor, ME 04538-1847

Mailing address

6 St. Andrews Lane
Lincoln Health Wound Care Center
Boothbay Harbor, ME 04578-1847
Phone (207) 633-1600

Other identifiers 2

IdentifierTypeStateIssuer
004246907MedicaidCT
1619953312MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000435 ME Practitioner - Nurse Practitioner 7810030368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Connecticut School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

35 Mile St
Damariscotta, ME 04543-4047
Phone (207) 563-1234

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1556CTMDAddiction (Substance Use Disorder) Counselor
001556CTMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients
Southern Maine Geriatrics Associates LLC Adult Health PastSince Mar 10, 2003 Accepting new patients

Locations

6 Saint Andrews Ln
Boothbay Hbr, ME 04538
Phone (207) 633-1928

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

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

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

Interoperability endpoints

  • Direct secure messaging: brademacherflis108794@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.

Hospital & facility affiliations 3

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1619953312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ST. ANDREWS LANE",
            "address_2": "LINCOLN HEALTH WOUND CARE CENTER",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045781847",
            "telephone_number": "207-633-1600",
            "fax_number": "207-633-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ST. ANDREWS LANE",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045381847",
            "telephone_number": "207-633-1600",
            "fax_number": "207-633-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADEMACHER-FLIS",
        "first_name": "BONNIE",
        "middle_name": "L.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CT",
            "license": "001556",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP121078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004246907",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619953312",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boothbay Harbor, ME

Sources for this page

Verify at the official NPI Registry.