Individual provider Active NPI

Giselle L Robertson, FNP

  • Family Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1780849398
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R040963 Issued in ME
Practice address
1365 Broadway
Bangor, ME 04401-2401
Phone
(207) 942-6226
Fax
(207) 992-2756
NPI assigned
Jul 23, 2008
Last updated
Mar 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R040963 ME Primary

Addresses

Primary practice location

1365 Broadway
Bangor, ME 04401-2401

Mailing address

1365 Broadway
Bangor, ME 04401-2401
Phone (207) 942-6226

Other practice location 1

37 Clinic Rd
Eleanor Widener Dixon Memorial Clinic
Gouldsboro, ME 04607-4013
Phone (207) 963-4066

Other practice location 2

37 Clinic Rd
Eleanor Widener Dixon Memorial Clinic
Gouldsboro, ME 04607
Phone (207) 963-4066

Other practice location 3

37 Clinic Rd
Eleanor Widener Dixon Memorial Clinic
Gouldsboro, ME 04607
Phone (207) 963-4066

Other names 1

  • Giselle L Renski Former name

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
I20081203000421 ME Practitioner - Nurse Practitioner 9335200807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Pain Management PCGroup PAC ID 1759355860, 13 clinicians

Practice addresses (Care Compare)

1365 Broadway
Bangor, ME 04401-2401
Phone (207) 942-6226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.43 of 100Reported as group
Quality
8.29
Promoting interoperability
100
Improvement activities
0
Cost
66.46

Merit-based Incentive Payment System (MIPS)

Final score
95.26 of 100Reported as group
Quality
96.06
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R040963MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Pain Management, PC CurrentSince Oct 16, 2017 Accepting new patients

Locations

1365 Broadway
Bangor, ME 04401
Phone (207) 942-2233

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1780849398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012401",
            "telephone_number": "207-942-6226",
            "fax_number": "207-992-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012401",
            "telephone_number": "207-942-6226",
            "fax_number": "207-992-2756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Clinic Rd",
            "address_2": "Eleanor Widener Dixon Memorial Clinic",
            "address_purpose": "LOCATION",
            "city": "Gouldsboro",
            "state": "ME",
            "postal_code": "046074013",
            "country_code": "US",
            "telephone_number": "207-963-4066",
            "fax_number": "207-963-7723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Clinic Rd",
            "address_2": "Eleanor Widener Dixon Memorial Clinic",
            "address_purpose": "LOCATION",
            "city": "Gouldsboro",
            "state": "ME",
            "postal_code": "04607",
            "country_code": "US",
            "telephone_number": "207-963-4066",
            "fax_number": "207-963-7723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Clinic Rd",
            "address_2": "Eleanor Widener Dixon Memorial Clinic",
            "address_purpose": "LOCATION",
            "city": "Gouldsboro",
            "state": "ME",
            "postal_code": "04607",
            "country_code": "US",
            "telephone_number": "207-963-4066",
            "fax_number": "207-963-7723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GISELLE",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R040963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GISELLE",
            "last_name": "RENSKI",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.