Individual provider Active NPI

Ronald E Bailyn, MD

  • Psychiatry Physician
  • Portland, ME
National Provider Identifier
1699772772
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
011874 Issued in ME
Practice address
121 Middle St
Suite 404
Portland, ME 04101-4156
Phone
(207) 772-8634
Fax
(207) 772-1629
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 011874 ME Primary
Geriatric Psychiatry Physician 2084P0805X 011874 ME

Addresses

Primary practice location

121 Middle St
Suite 404
Portland, ME 04101-4156

Mailing address

20 Adelbert St
South Portland, ME 04106-6512
Phone (207) 772-8634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011874MEMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: rbailyn30713@direct.mmc.mainehealth.org

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1699772772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ADELBERT ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066512",
            "telephone_number": "207-772-8634",
            "fax_number": "207-772-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MIDDLE ST",
            "address_2": "SUITE 404",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014156",
            "telephone_number": "207-772-8634",
            "fax_number": "207-772-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILYN",
        "first_name": "RONALD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "011874",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "ME",
            "license": "011874",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.