Individual provider Active NPI

Michael C Mattingly, M.D.

  • Pediatric Cardiology Physician
  • Bangor, ME
National Provider Identifier
1659549681
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
26254 Issued in MS
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 973-7000
NPI assigned
Feb 12, 2008
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 26254 MS Primary
Pediatrics Physician 208000000X 26254 MS

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

489 State St
Bangor, ME 04401-6616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190405000357 MS Practitioner - Pediatric Medicine 4486883444 Reassigns benefits to 1 organization
I20260313004163 ME Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 4486883444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Cardiovascular Disease (Cardiology)
Education
University of Miami, LM Miller School of Medicine, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

43 Whiting Hill Rd
Suite 250
Brewer, ME 04412-1018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26254MSMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Apr 27, 2026 Accepting new patients
Southern Specialty Clinic, LLC CurrentSince Oct 26, 2024 Accepting new patients
Southern Specialty Clinic, LLC Pediatric Cardiology CurrentSince Jan 1, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince Apr 27, 2026 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

57 Water St
Blue Hill, ME 04614
Phone (207) 374-3400

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

803 Liberty Rd
Flowood, MS 39232
Phone (601) 714-1967

Interoperability endpoints

  • Direct secure messaging: mmattingly210160@direct.bmhcc.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1659549681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MS",
            "license": "26254",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "26254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.