Individual provider Active NPI

Mark Kunstman, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1780609453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ME249144 Issued in ME
Practice address
268 Stillwater Ave
Acadia Hospital Corporation
Bangor, ME 04401
Phone
(207) 973-6100
Fax
(207) 973-6109
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ME249144 ME Primary

Addresses

Primary practice location

268 Stillwater Ave
Acadia Hospital Corporation
Bangor, ME 04401

Mailing address

PO Box 422
Acadia Hospital Corporation
Bangor, ME 04402-0422
Phone (207) 973-6100

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000678 ME Practitioner - Clinical Social Worker 0840234266 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

35 Medical Ctr Pkwy
Augusta, ME 04330-8160
Phone (207) 621-1000

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ME249144MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Aug 1, 2002 Accepting new patients
Mainegeneral Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Mainegeneral Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Eastern Maine Medical Center CurrentSince Jan 1, 2008 Accepting new patients
Eastern Maine Medical Center CurrentSince Jan 1, 2008 Accepting new patients
Acadia Healthcare, Inc Past Accepting new patients

Locations

35 Medical Center Pkwy
Augusta, ME 04330
Phone (207) 621-3639

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

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

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 6

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780609453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 422",
            "address_2": "ACADIA HOSPITAL CORPORATION",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020422",
            "telephone_number": "207-973-6100",
            "fax_number": "207-973-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "address_2": "ACADIA HOSPITAL CORPORATION",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-973-6100",
            "fax_number": "207-973-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNSTMAN",
        "first_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "ME249144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.