Individual provider Active NPI

Marianne Decain Tarraza, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, ME
National Provider Identifier
1780646430
Registry record updated Mar 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP81164 Issued in ME
Practice address
165 Lancaster St
Portland, ME 04101-2406
Phone
(207) 874-1030
Fax
(207) 874-1044
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN38186 ME
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP81164 ME Primary

Addresses

Primary practice location

165 Lancaster St
Portland, ME 04101-2406

Mailing address

PO Box 2328
South Portland, ME 04116-2328
Phone (207) 799-9888

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
I20090326000241 ME Practitioner - Nurse Practitioner 4587629936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Pleasant Hill Rd
Suite 204
Scarborough, ME 04074-9688
Phone (207) 799-9888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN38186MEMDPsychiatric/Mental Health Registered Nurse
CNP81164MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Mar 18, 2019 Accepting new patients
Marianne Decain Tarraza NP, LLC CurrentSince Jun 2, 2012 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Mar 18, 2019 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

165 Lancaster St
Portland, ME 04101
Phone (207) 874-1030

15 Pleasant Hill Rd
Ste 204
Scarborough, ME 04074
Phone (207) 290-8978

78 Atlantic Pl
South Portland, ME 04106
Phone (207) 661-6654

123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553990400000",
    "number": "1780646430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2328",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041162328",
            "telephone_number": "207-799-9888",
            "fax_number": "207-799-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LANCASTER ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012406",
            "telephone_number": "207-874-1030",
            "fax_number": "207-874-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARRAZA",
        "first_name": "MARIANNE",
        "middle_name": "DECAIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2019-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ME",
            "license": "RN38186",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP81164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.