NPIMap

Individual provider Active NPI

Marissa P Tardif, FNP

  • Family Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1821635020
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP191212 Issued in ME
Practice address
92 Campus Dr Ste B
Scarborough, ME 04074-7229
Phone
(207) 777-8810
Fax
(207) 777-8155
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 CNP191212 ME Primary

Addresses

Primary practice location

92 Campus Dr Ste B
Scarborough, ME 04074-7229

Mailing address

92 Campus Dr Ste B
Scarborough, ME 04074-7229
Phone (207) 885-4362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200127000175 ME Practitioner - Nurse Practitioner 2163857871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Wellness Way
Suite a
Topsham, ME 04086-1768
Phone (207) 406-7600

100 Brickhill Ave
South Portland, ME 04106-1999

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP191212MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary'S Regional Medical Center CurrentSince Dec 16, 2019 Accepting new patients
Mainehealth Family CurrentSince Jul 15, 2024 Accepting new patients
St. Mary'S Regional Medical Center CurrentSince Dec 16, 2019 Accepting new patients
St. Mary'S Regional Medical Center Current Accepting new patients
Mainehealth CurrentSince Jul 15, 2024 Accepting new patients
Mainehealth Current Accepting new patients

Locations

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

99 Campus Ave
Ste 201
Lewiston, ME 04240
Phone (207) 777-5300

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

92 Campus Dr
Ste B
Scarborough, ME 04074
Phone (207) 662-5143

Interoperability endpoints

  • Direct secure messaging: mtardif716227@direct.mmc.mainehealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1821635020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE B",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-885-4362",
            "fax_number": "207-883-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE B",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747229",
            "telephone_number": "207-777-8810",
            "fax_number": "207-777-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARDIF",
        "first_name": "MARISSA",
        "middle_name": "P",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP191212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.