Individual provider Active NPI

Nicholas Miles, MD

  • Child Abuse Pediatrics Physician
  • Portland, ME
National Provider Identifier
1861854119
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X
License
MD25720 Issued in ME
Practice address
901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone
(207) 871-1200
Fax
(207) 871-1232
NPI assigned
Mar 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Abuse Pediatrics Physician 2080C0008X MD25720 ME Primary

Addresses

Primary practice location

901 Washington Ave Ste 100
Portland, ME 04103-2842

Mailing address

901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone (207) 871-1200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004001212 ME Practitioner - Pediatric Medicine 5092191783 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD25720MEMDChild Abuse Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Jul 18, 2022 Accepting new patients
Spurwink Services Incorporated PastSince Jul 18, 2022 Accepting new patients

Locations

139 State St
#1
Bangor, ME 04401

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

9 Hillcrest Ave
Randolph, ME 04346
Phone (207) 582-9205

778 Main St
South Portland, ME 04106
Phone (207) 775-7758

Organizations & group practices 2

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1861854119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON AVE STE 100",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032842",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON AVE STE 100",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032842",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-25",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "ME",
            "license": "MD25720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.