Active NPI
Ottilia Boros, FNP-C
- Family Medicine Physician
- Bangor, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- CNP241459
- Practice address
- 1012 Union St
Bangor, ME 04401-3060 - Phone
- (207) 404-8100
- NPI assigned
- Jul 25, 2024
- Last updated
- Sep 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | CNP241459 | ME | Primary |
Addresses
Primary practice location
1012 Union St
Bangor, ME 04401-3060
Mailing address
PO Box 1599
Bangor, ME 04402-1599
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1012 Union St
Bangor, ME 04401-3058
1068 Union St
Bangor, ME 04401-3016
Phone (207) 404-8181
242 Brunswick St
Old Town, ME 04468-1613
Phone (207) 827-6128
992 Union St
Bangor, ME 04401-3057
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP241459 | ME | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Community Health Center | Current | Accepting new patients | |
| Penobscot Community Health Center | Current | Accepting new patients | |
| Penobscot Community Health Center | Current | Accepting new patients |
Locations
1012 Union St
Bangor, ME 04401
Phone (207) 404-8200
1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407
Organizations & group practices 3
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.
-
dba Penobscot Community Health Care
- Federally Qualified Health Center (FQHC)
- Bangor, ME
- NPI 1427169010
-
dba Adult Wellness Center
- Federally Qualified Health Center (FQHC)
- Bangor, ME
- NPI 1083259410
-
dba Penobscot Pediatrics
- Federally Qualified Health Center (FQHC)
- Bangor, ME
- NPI 1568555498
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CenterWell Home Health
- Home Health Agency
- Bangor, ME
- NPI 1982638771
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1790789147
-
- General Acute Care Hospital
- Bangor, ME
- NPI 1154321545
-
dba Northern Light Home Care & Hospice
- Home Health Agency
- South Portland, ME
- NPI 1245236306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1821826371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1599",
"city": "BANGOR",
"state": "ME",
"postal_code": "044021599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 UNION ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013060",
"telephone_number": "207-404-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOROS",
"first_name": "OTTILIA",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-25",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "CNP241459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.