Mark Piccirillo, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD12499 Issued in ME

Practice address

489 State St
Bangor, ME 04401-6616

Phone

(207) 973-8150

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Spectrum Medical Group, P.a.

  • Diagnostic Radiology Physician
  • Bangor, ME
  • NPI 1639577620
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1720162290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 GANNETT DR STE 200",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063266",
            "telephone_number": "207-482-7800"
        },
        {
            "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": "207-973-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIRILLO",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD12499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Philp, LMT
• Cynthia A Phinney, MA
• Phoenix Mental Health Services, LLC
• Physicians Specialists Surgery Center of Maine PLLC
• Lawrence Piazza, M.D.
• Deborah L Pickering, PMHNP
• Michelle F Pickoski-Capuano, FNPC
• Claudia R Picone, MD
• Abigail Hamel Pierce, LCSW, CADC
• Jolene Pierce, RDH, IPDH

• Diagnostic Radiology Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Diagnostic Radiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.