Alison Moore Tetrault, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP201021 Issued in ME

Practice address

17 Bishop St
Portland, ME 04103-2659

Phone

(207) 835-0488

Fax

(207) 835-0358

NPI assigned

Nov 1, 2019

Last updated

Nov 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

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

R.I.S.E. Integrated Mental Health PLLCGroup PAC ID 6305372210, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atetrault144855@direct.mmc.mainehealth.org

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.

• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment Care Compare group NPD
• R.I.S.E. Integrated Mental Health PLLC

  • Psychiatry Physician
  • York, ME
  • NPI 1467200899
  Medicare reassignment Care Compare group NPD
• Bishop Medical Group LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Portland, ME
  • NPI 1487256186
  Medicare reassignment NPD
• Mainehealth

  dba MaineHealth Pharmacy Brighton Ave

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  dba MaineHealth Maine Medical Center

  • General Acute Care Hospital
  • Portland, ME
  • NPI 1508897059
  NPD

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1851935878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BISHOP ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032659",
            "telephone_number": "207-835-0488",
            "fax_number": "207-835-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BISHOP ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032659",
            "telephone_number": "207-835-0488",
            "fax_number": "207-835-0358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Beacon St E",
            "address_purpose": "LOCATION",
            "city": "Laconia",
            "state": "NH",
            "postal_code": "032463437",
            "country_code": "US",
            "telephone_number": "603-524-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Andover Rd",
            "address_purpose": "LOCATION",
            "city": "Westbrook",
            "state": "ME",
            "postal_code": "040923850",
            "country_code": "US",
            "telephone_number": "207-761-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 June St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732621",
            "country_code": "US",
            "telephone_number": "207-324-4310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "ALISON",
        "middle_name": "MOORE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP201021",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ME",
            "license": "68812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Devin Shaughnessy Tetler, AGPCNP-BC
• Deborah R Tetreault, WHNP
• Colleen Tetzlaff, FNP
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• The Dental Loft

• Psychiatric/Mental Health Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; 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.

Verify at the official NPI Registry.