Deirdre Burns Mondor, M.D.
Individual provider Active NPI Pediatrics Physician · Kennebunk, ME
NPI 1710399530 · NPPES record last updated Nov 29, 2023
Key facts
- NPI
- 1710399530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- FB6877027 (ME)
- Practice address
- 3 Shape Dr
Kennebunk, ME 04043-6601 - Phone
- (207) 467-8930
- NPI assigned
- May 28, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231017002830 | ME | Practitioner - Pediatric Medicine | 1355567272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A14973 | CA | MD | Pediatrics Physician |
| FB6877027 | ME | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current |
Accepting new patients | |
| Mainehealth | Current |
Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients | |
| Mainehealth | Pediatrics | Past | Accepting new patients |
Locations
1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000
3 Shape Dr
Kennebunk, ME 04043
Phone (207) 467-8930
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- dburns16566@direct.mmc.mainehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A14973 | CA | |
| Pediatrics Physician | 208000000X | FB6877027 | ME | Yes |
Addresses
Primary practice location
3 Shape Dr
Kennebunk, ME 04043-6601
Mailing address
3 Shape Dr
Kennebunk, ME 04043-6601
Phone (207) 467-8930
Other practice location 1
25 Allen St
Martinez, CA 94553-3156
Phone (925) 313-7932
Other providers in Kennebunk, ME
- Philip Washburn Browne
- Timothy Bernard Bruhl
- Erika Kristin Bruns Montemerlo
- Andrew Michael Bruns
- Donald R Burgess
- Allison Burt
- Dorothy Adair Burton
- Nicole Butler
- Calvin P Fuhrmann MD PA
- Cecily Cannon
All providers in Kennebunk, ME · Pediatrics Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.