Individual provider Active NPI

Becca R Buzanoski, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Newport, ME
National Provider Identifier
1720977572
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP251354 Issued in ME
Practice address
341 Moosehead TRL
Newport, ME 04953-4019
Phone
(207) 973-6100
NPI assigned
Jun 28, 2025
Last updated
Jun 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP251354 ME Primary

Addresses

Primary practice location

341 Moosehead TRL
Newport, ME 04953-4019

Mailing address

341 Moosehead TRL
Newport, ME 04953-4019
Phone (207) 356-1828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016000137 ME Practitioner - Nurse Practitioner 7911494612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

268 Stillwater Ave
Bangor, ME 04401-3945

268 Stillwater Ave
Bangor, ME 04401-3980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Sep 14, 2025 Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

Organizations & group practices 1

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": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1720977572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MOOSEHEAD TRL",
            "city": "NEWPORT",
            "state": "ME",
            "postal_code": "049534019",
            "telephone_number": "207-356-1828",
            "fax_number": "207-356-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MOOSEHEAD TRL",
            "city": "NEWPORT",
            "state": "ME",
            "postal_code": "049534019",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZANOSKI",
        "first_name": "BECCA",
        "middle_name": "R",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP251354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, ME

Sources for this page

Verify at the official NPI Registry.